Figure 1. A suggested flow chart for the management of recurrent primary CBDS according to risk factors. CBDS: common bile duct stone.
| Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access |
| Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc |
| Journal website https://www.jocmr.org |
Review
Volume 14, Number 11, November 2022, pages 441-447
Primary Recurrent Common Bile Duct Stones: Timing of Surgical Intervention
Figure
Table
| Level of risk | Risk factors |
|---|---|
| Metabolic-related factors: obesity, hyperlipidemia, hypercalcemia, hyperuricemia, insulin resistance diabetes mellitus and fatty liver. CBDS: common bile duct stone; ERCP: endoscopic retrograde cholangiopancreatography; PPIs: proton pump inhibitors. | |
| High risk | Age older than 65 years old; Genetic mutations (ABCB4 gene mutation); Dilated CBD (more than 15 mm); Periampullary duodenal diverticulum; Previous ERCP with endoscopic sphincterotomy |
| Intermediate risk | Stone diameter (more than 1 cm); Multiple stones (more than 1); ERCP with balloon dilation; ERCP with stent insertion |
| Low risk | Female gender; Metabolic-related factors; Drugs (PPIs) |