STUDY: Significance of bile duct sludge- different from bile duct stones?

[Guest guest]

Surg Endosc. 2007

Mar 7; [Epub ahead of print]

The

clinical significance of bile duct sludge: is it different from bile duct

stones?

Keizman D, Ish-Shalom M, Konikoff FM.

Department of Gastroenterology, Tel Aviv

University, Tel Aviv, Israel,

BACKGROUND: Some patients with suspected common bile duct (CBD) stones are

found to have sludge and no stones. Although sludge in

the gallbladder is a precursor of gallbladder stones, the significance of bile

duct sludge (BDS) is poorly defined. This study aimed

to compare BDS with bile duct stones in terms of frequency, associated risk

factors, and clinical outcome after endoscopic

therapy. METHODS: The study enrolled 228 patients who

underwent therapeutic endoscopic retrograde cholangiopancreatography (ERCP) for suspected choledocholithiasis. The patients

were divided into two groups: patients with BDS but no stones on ERCP and

patients with CBD stones. The presence of risk factors

for bile duct stones (age, periampullary diverticulum, ductal dilation or angulation, previous open cholecystectomy)

were assessed at ERCP. Follow-up data (36 +/- 19

months) were obtained from medical records and by patient questioning. RESULTS: Bile duct sludge occurred in 14% (31/228) of

patients and was more common in females. After endoscopic clearance, CBD stones recurred in 17% (33/197)

of the patients with CBD stones, and in 16% (5/31) of the patients with BDS (p

= 0.99). Common bile duct dilation was less common in

the sludge group. The other known risk factors for

recurrent CBD stones (age, previous open cholecystectomy,

bile duct angulation, and the presence of a peripampullary diverticulum) were

not statistically different between the two groups. CONCLUSIONS: The findings indicate that the

clinical significance of symptomatic BDS is similar to that of CBD stones. Bile duct sludge seems to be an early stage of choledocholithiasis. PMID: 17342562 [PubMed

- as supplied by publisher]

Barb in Texas - Together in the Fight, Whatever it Takes!

Son Ken (32) UC 91 - PSC 99 Listed 7/21 @ Baylor Dallas