{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T05:33:12Z","timestamp":1740547992531,"version":"3.38.0"},"reference-count":16,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T00:00:00Z","timestamp":1736726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hepatolithiasis frequently presents with recurring cholangitis and complications. Oddi sphincter\u2010preserved cholangioplasty with hepatico\u2010subcutaneous stoma (OSPCHS), introduced in 1993, has shown favorable long\u2010term results. Endoscopic sphincterotomy (EST) is commonly used, but its impact on OSPCHS outcomes remains unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From January 1993 to June 2021, 254 patients with hepatolithiasis underwent OSPCHS. A total of 31 patients had prior EST (group with EST, <jats:italic>n<\/jats:italic>\u2009=\u200931), while 223 did not (group without EST, <jats:italic>n<\/jats:italic>\u2009=\u2009223). Perioperative and long\u2010term outcomes were compared, and risk factors for stone and cholangitis recurrence were analyzed using a Cox regression model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The immediate and final stone clearance rates were 67.3% and 81.9%, respectively. Patients with prior EST had higher rates of stone recurrence (57.7% vs. 35.7%, <jats:italic>p<\/jats:italic>\u2009=\u2009.031), shorter stone\u2010free duration (median: 51.5 vs. 112.0\u2009months, <jats:italic>p<\/jats:italic>\u2009=\u2009.001), higher cholangitis recurrence (45.2% vs. 25.6%, <jats:italic>p<\/jats:italic>\u2009=\u2009.023), and shorter cholangitis\u2010free duration (median: 71.0 vs. 134.0\u2009months, <jats:italic>p<\/jats:italic>\u2009=\u2009.006). Multivariable analysis identified bilateral intrahepatic stones (HR: 1.815, <jats:italic>p<\/jats:italic>\u2009=\u2009.010) and prior EST (HR: 3.157, <jats:italic>p<\/jats:italic>\u2009=\u2009.000) as independent risk factors for stone recurrence, whereas combined hepatectomy was a protective factor (HR: 0.448, <jats:italic>p<\/jats:italic>\u2009=\u2009.001). For cholangitis recurrence, male gender (HR: 2.308, <jats:italic>p<\/jats:italic>\u2009=\u2009.001) and EST (HR: 2.241, <jats:italic>p<\/jats:italic>\u2009=\u2009.009) were independent risk factors, while complete stone clearance reduced recurrence risk (HR: 0.423, <jats:italic>p<\/jats:italic>\u2009=\u2009.002).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Prior EST adversely affects the long\u2010term outcomes of OSPCHS. Therefore, in the management of hepatolithiasis, emphasis should be placed on preserving the Oddi sphincter.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhbp.12107","type":"journal-article","created":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T09:11:48Z","timestamp":1736759508000},"page":"168-176","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Influence of endoscopic sphincterotomy on hepatolithiasis with Oddi sphincter\u2010preserved cholangioplasty with hepatico\u2010subcutaneous stoma: A three\u2010decade, real word cohort study"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3539-9168","authenticated-orcid":false,"given":"Xue","family":"Yu","sequence":"first","affiliation":[{"name":"Department of General Surgery Peking University Third Hospital  Beijing 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Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lixin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of General Surgery Peking University Third Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chunsheng","family":"Hou","sequence":"additional","affiliation":[{"name":"Department of General Surgery Peking University Third Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lingfu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of General Surgery Peking University Third Hospital  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2647-4020","authenticated-orcid":false,"given":"Xiaofeng","family":"Ling","sequence":"additional","affiliation":[{"name":"Department of General Surgery Peking University Third Hospital  Beijing 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