Right posteroinferior bile duct angulation correlates with bile duct stone occurrence in patients with hepatolithiasis
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HEPATOBILIARY
Right posteroinferior bile duct angulation correlates with bile duct stone occurrence in patients with hepatolithiasis Guangyu Chen1,2 · Jun Wu2,3 · Le Xiao1,2 · Yi Wen1,2 · Tian Yang4 · Shuguang Wang1
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose This study aimed to examine the correlation between right posteroinferior bile duct (RPBD) angulation and the occurrence of bile duct stones in patients with hepatolithiasis. Methods Patients presenting with hepatolithiasis in our hospital from January 2011 to July 2016 were divided into two groups according to whether their RPBD was affected by stones. A statistical analysis for the relevant factors associated with bile duct stone formation in the RPBD was performed. Results The binary logistic regression results showed that stenosis of the right hepatic duct [odds ratio (OR): 7.313; 95% confidence interval (CI) 4.131–12.945)] and the angle of the RPBD (OR 0.896; 95%CI 0.877–0.916) were risk factors associated with the formation of RPBD stones. Further, the receiver operating characteristic curve indicated that, when the angle of the RPBD was less than 44.58°, stones were able to form more easily in the RPBD. Conclusion The occurrence of bile duct stones is well correlated with sharp bile duct angulation. Keywords Right posteroinferior bile duct · Bile duct angulation · Hepatolithiasis · Bile duct stone
Introduction Hepatolithiasis is a common disease in the Asia–Pacific region. Effectively preventing and treating the formation and recurrence of bile duct stones remains a worldwide problem [1]. With the development of medical imaging technology, the distribution of bile duct stones in the biliary Guangyu Chen, Jun Wu, Le Xiao, and Yi Wen have contributed equally to this work. * Tian Yang [email protected] * Shuguang Wang [email protected] 1
Hepatobiliary Surgery Institute, Southwest Hospital, Army Medical University, No. 29 Gaotanyan Street, Shapingba District, Chongqing, China
2
The General Hospital of Western Theater Command, Chengdu, China
3
College of Medicine, Southwest Jiaotong University, Chengdu, China
4
Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China
tree in patients with hepatolithiasis can be more accurately determined [2]. It is believed that cholestasis is an important cause of hepatolithiasis. A common cause of cholestasis is inflammatory stricture of the bile duct wall [3], but other possible causes of cholestasis may exist as well. In our clinical work, we found that the angle between the right posteroinferior bile duct (RPBD) and the vertical axis of the human body was smaller in patients with stones in the RPBD. Based on this finding, we questioned whether or not it is because of the increased resistance of bile outflow that the bile becomes relatively stagnant, leading to the formation of stones. Further, we wondered whether an angle value that could be used to help predict a high occurrence
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