To explore the risk factors of recurrence of gallbladder and common bile duct stones by endoscopic retrograde cholangiopancreatography (ERCP) combined with laparoscopic cholecystectomy (LC).

From January 2012 to March 2015, eighty-seven cases with cholecystolithiasis complicated with choledocholithiasis diagnosed in Shuyang People’s Hospital were analyzed retrospectively, all of whom were treated with ERCP combined with LC. Clinical data were collected and the patients were divided into recurrence group and non-recurrence group, according to recurrence of stones. Univariate factor analysis and multivariate Logistic regression analysis were performed to identify the risk factors forpostoperative stone recurrence.

Sixty-six cases of non-recurrence group and twenty-one cases of recurrence group were followed up for 32-60 months with a median of 48 months. The median recurrence time was 15.0 months (95% CI=12.5-20.0). The recurrence rates were 8.0%, 23.0% and 24.1% at 1, 2, and 3 years after operation, respectively, the recurrence mainly occurred within 2 years after operation. Univariate analysis showed that biliary tract infection, biliary stricture, common bile duct angle, the number of stones, stone size, nipple diverticula affected the recurrence of cholecystolithiasis with common bile duct stones (all P<0.05). Multivariate analysis showed that common bile duct angle (OR=0.196, 95% CI=0.044-0.877), biliary tract infection (OR=6.894, 95% CI=1.698-27.984), peripapillary diverticulum (OR=10.554, 95% CI=2.134-52.197), and Oddi sphincterotomy (OR=17.803, 95% CI=3.342-94.845) were independent risk factors for recurrence of cholecystolithiasis after cholecystectomy.

Patients with small common bile duct angle, biliary tract infection, peripapillary diverticulum, and intraoperative oddi sphincterotomy are more likely to recur after ERCP combined with LC. It can be used for reference in further clinical prevention and treatment.