Work

Association Between Concomitant Gallstones and Late Biliary Adverse Events After Endoscopic Papillectomy

Year: 2026

Type: article

Abstract: BACKGROUND/PURPOSE: Late adverse events (AEs) following endoscopic papillectomy (EP) are poorly characterized. We examined the association between concomitant gallstones (GS) and late AEs after EP. METHODS: We retrospectively analyzed patients undergoing EP for ampullary tumors between 2004 and 2025. Late AEs were symptomatic pancreatobiliary events occurring ≥ 30 days after EP and requiring medical intervention. Analyses included patients with intact gallbladders. The primary outcome was time to the first late AE; secondary analyses evaluated its biliary or pancreatic phenotype using age- and sex-adjusted Cox models. RESULTS: Of 313 patients, 292 had intact gallbladders, including 54 with GS and 238 without GS. Late AEs occurred in 25.9% and 10.5%, respectively. GS was associated with the first late AE (adjusted hazard ratio [aHR], 2.97; 95% confidence interval [CI], 1.53-5.75) and its biliary phenotype (aHR, 3.58; 95% CI: 1.71-7.49) but not its pancreatic phenotype. One-year cumulative incidence of the first late AE was 23.2% versus 5.7% (log-rank, p < 0.001). Among the 43 patients with late AEs overall, 35 (81.4%) underwent endoscopic retrograde cholangiopancreatography, and nine (20.9%) experienced recurrence. CONCLUSIONS: Concomitant GS was associated with late AEs after EP and may be a risk marker for late biliary events.

Source: Journal of Hepato-Biliary-Pancreatic Sciences

DOI: 10.1002/jhbp.70221