Objective  To explore the long-term effect of the cholagogic drug in preventing the recurrence of common bile duct stones after endoscopic retrograde cholangiopancreatography (ERCP).

Methods  The clinical data of patients who underwent ERCP choledocholithotomy within 2017 were analyzed retrospectively, including the age, the proportion of first-time ERCP and repeated ERCP, whether the ERCP patients were treated with stents, whether the patients took cholagogic drugs, stone recurrence rate. The relationship between stone recurrence and duodenal papillary diverticulum was analyzed. The patients at high risk of recurrence were selected, and were advised to take Danning tablets above 24 weeks, and the recurrence of stones was observed.

Results  A total of 911 patients with common bile duct stones underwent ERCP, including 457 males and 454 females, with a median age of 69 years old. 605 patients underwent ERCP for the first time, and 306 patients had undergone lithotomy or papillotomy before. 370 patients received biliary stents, among whom, 301 patients received the first-time ERCP, and the other 69 patients were replaced previous biliary stents during the repeated ERCP (49.8% vs 22.5%, P < 0.000 1). Of the 605 patients received first-time ERCP, 253 cases had parapapillary diverticulum, and 176 cases had stone recurrence. The rate of stone recurrence in the patients with diverticulum was significantly higher than that in the patients without diverticulum (34.0% vs 25.6%, P < 0.05). 160 patients were enrolled into the treatment group and control group, with 80 patients in each group. 58 patients in the treatment group (taking Danning tablets over 24 weeks) and 64 patients in the control group (taking Danning tablets shorter than 12 weeks) were followed up to 24 weeks or the end point of recurrence of stones or acute cholangitis occurance. A total of 21 (17.2%) patients had stones recurrence, including 5 (8.6%) patients in the treatment group, and 16 (25.0%) in the control group (P < 0.05).

Conclusion  After repeated ERCP treatment, the rate of biliary stent implantation in patients with common bile duct stones reduced, and duodenal papillary diverticulum is related to stone recurrence. Danning tablets and other cholagogic drugs can help reduce the recurrence rate of stones, but need to be taken over 24 weeks.