Addiction and the Risk of Common Bile Duct Stones: A ۴-Year Retrospective Population-Based Study in Mashhad, Iran

Background: As a common digestive disorder, choledocholithiasis can have serious consequences, including death. Given that opioids have been shown to contribute to the spasm of Oddi’s sphincter, which results in biliary stasis in the common bile duct (CBD), it is likely that opioids can also raise the prevalence of choledocholithiasis. In this regard, this study aimed to investigate how common opium addiction was among choledocholithiasis patients in Mashhad, Iran.Methods: The current retrospective observational study was conducted on ۵۹۹ patients with choledocholithiasis who underwent endoscopic retrograde cholangiopancreatography (ERCP), utilizing information gathered at the Ghaem hospital in Mashhad, Iran, between ۲۰۱۱ and ۲۰۱۵. Patient data were collected from files and records using certain criteria such as gender, opium addiction, hepatic enzymes (AST, ALT, ALP), plasma levels of total bilirubin, and direct bilirubin. The size of the CBD stones as well as the correlation between the gallbladder and CBD stones were calculated.Findings: From among ۵۹۹ patients included, ۳۴۵ (۵۷.۶%) were female and ۲۵۴ (۴۲.۴%) were male. Moreover, ۱۹۵ patients (۳۲.۲%) had opiate addictions. The size of the CBD stone was correlated with the patient’s age (r=۰.۱۷, P=۰.۰۰۱). The average stone measured ۱۲.۲۲±۳.۳۲ mm. There were notable differences in the mean size of the CBD stone (P<۰.۰۰۱) between addicted and non-addicted cases; specifically, the mean CBD stone size in addicted cases was ۱۲.۷۱۵.۱۳ mm while it was ۱۲.۳۴.۳۳ mm in non-addicted cases.Conclusion: This study showed patients with CBD stones have a higher rate of opium addiction compared to the general population, indicating a possible link between the two conditions.

Keywords:

CBD stone , Choledocholithiasis , Addiction