Related Experiment Video
Updated: Feb 17, 2026
Laparoscopic Common Bile Duct Exploration Followed by Primary Suture Using a Modified Bile Duct Incision
Published on: May 2, 2025
A nationwide population-based study of common bile duct stone recurrence after endoscopic stone removal in Korea
Byung Kyu Park1, Jeong Hun Seo2, Han Ho Jeon1
1Division of Gastroenterology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
Insights
Patients undergoing endoscopic common bile duct (CBD) stone removal have a low first recurrence rate but high subsequent rates. Cholecystectomy is recommended for younger patients with gallbladder stones to reduce CBD stone recurrence.
Area of Science:
- Gastroenterology
- Hepatobiliary Surgery
Background:
- Lack of consensus exists regarding follow-up protocols for patients after endoscopic common bile duct (CBD) stone removal.
- The necessity of cholecystectomy in patients with gallbladder (GB) stones remains debated, particularly concerning its impact on CBD stone recurrence.
Purpose of the Study:
- To investigate the recurrence rate of CBD stones after endoscopic removal.
- To evaluate the impact of cholecystectomy on the recurrence rate of CBD stones.
Main Methods:
- A population-based study utilizing the National Health Insurance database.
- Inclusion criteria: patients diagnosed with CBD stones and registered for endoscopic stone removal.
- Outcomes assessed: primary - CBD stone recurrence rate; secondary - difference in recurrence rate based on cholecystectomy status.
Main Results:
- Over 46,000 patients were analyzed with a mean follow-up of 4.2 years.
- The cumulative first CBD stone recurrence rate was 11.3%, with significantly higher second (23.4%) and third (33.4%) recurrence rates.
- The recurrence rate was substantially higher in patients who did not undergo cholecystectomy compared to those who did (p < 0.0001), with increased risk in younger age groups.
Conclusions:
- Routine follow-up is not advised for first-time endoscopic CBD stone removal patients, but is recommended for those with recurrent stones.
- Cholecystectomy is recommended for patients with GB stones younger than 70 years to mitigate CBD stone recurrence risk.
Background:
There is no consensus whether patients who underwent endoscopic common bile duct (CBD) stone removal should be followed up periodically and whether patients with gallbladder (GB) stones should undergo cholecystectomy. Thus, this study aimed to investigate the recurrence rate of CBD stones and the difference in recurrence rate according to cholecystectomy.
Methods:
We conducted a population-based study using the National Health Insurance database. Patients diagnosed with CBD stones and with procedure registry of endoscopic stone removal were included. The primary outcome was the recurrence rate of CBD stones. The secondary outcome was the difference in recurrence rate of CBD stones according to cholecystectomy.
Results:
A total of 46,181 patients were identified. The mean follow-up was 4.2 years. The first CBD stone recurrence occurred in 5228 (11.3%) patients. The cumulative first recurrence rate was low. However, the second and third recurrence rates were 23.4 and 33.4%, respectively. The cumulative second and third recurrence rates were high and gradually increased with time. The recurrence rate in the non-cholecystectomy group was higher than that in the cholecystectomy group (p < 0.0001). The relative risk for CBD stone recurrence in the non-cholecystectomy group was higher in younger patients, with 3.198 in patients < 50 years, 2.371 in 50-59 years, 1.618 in 60-69 years, and 1.262 in ≥ 70 years (p < 0.0001).
Conclusions:
Regular follow-up is not routinely recommended for patients with first-time endoscopic stone removal, but is recommended for patients with recurrent stones. Cholecystectomy is recommended for patients with GB stones who are younger than 70 years.
More Related Videos
07:36Laparoscopic Common Bile Duct Exploration in Patients with a Previous History of Biliary Tract Surgery
Published on: February 10, 2023
04:02Laparoscopic Cholecystectomy with Indocyanine Green Fluorescence: Choledochoscopic Stone Extraction and Primary Duct Suture
Published on: November 25, 2025
