Background: Unnecessary endoscopic retrograde cholangiopancreatography (ERCP) after spontaneous passage of common bile duct stones (CBDSs) should be avoided. This study aimed to examine the cumulative diagnosis rate and the predictive factors of spontaneous CBDS passage during the interval between the imaging diagnosis and ERCP.
Methods: This multicenter retrospective study included 1260 consecutive patients with native papilla diagnosed with CBDSs using imaging modalities. Predictive factors and cumulative diagnosis rate of spontaneously passed CBDSs during the interval between imaging diagnosis and ERCP were analyzed.
Results: The overall cumulative diagnosis rate of spontaneous CBDS passage was 6.2% (78/1260) during a mean interval of 5.0 days. In the multivariate analysis, CBDS sized < 6 mm on diagnostic imaging, solitary CBDS on diagnostic imaging, intervals between the imaging diagnosis and ERCP, and nondilated common bile duct (< 10 mm) were the significant factors associated with spontaneous CBDS passage. Specifically, the cumulative diagnosis rate of spontaneous passage was significantly higher in patients with solitary and CBDSs sized < 6 mm than in those with other CBDSs (14.4% [54/376] vs. 2.7% [24/884], P < 0.001). In both the asymptomatic and symptomatic groups, the cumulative diagnosis rate of the spontaneous passage of CBDSs was significantly higher in patients with solitary and CBDSs sized < 6 mm on diagnostic imaging than in those with multiple and/or CBDSs sized ≥ 6 mm on diagnostic imaging during a mean interval of 20.5 and 2.4 days, respectively (asymptomatic group: 22.4% [15/67] vs. 3.5% [4/113], P < 0.001, symptomatic group: 12.6% [39/309] vs. 2.6% [20/771], P < 0.001).
Conclusions: Solitary and CBDSs sized < 6 mm on diagnostic imaging can often lead unnecessary ERCP due to spontaneous passage. Preliminary endoscopic ultrasonography immediately before ERCP is recommended, especially in patients with solitary and small CBDSs on diagnostic imaging.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00464-023-09954-3 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Association between SOFA score and risk of acute kidney injury in patients with diabetic ketoacidosis: an analysis of the MIMIC-IV database.
Front Endocrinol (Lausanne)
January 2025
Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Introduction: The Sequential Organ Failure Assessment (SOFA) score is a widely utilized clinical tool for evaluating the severity of organ failure in critically ill patients and assessing their condition and prognosis in the intensive care unit (ICU). Research has demonstrated that higher SOFA scores are associated with poorer outcomes in these patients. However, the predictive value of the SOFA score for acute kidney injury (AKI), a common complication of diabetic ketoacidosis (DKA), remains uncertain.
View Article and Find Full Text PDFSuperior efficacy of intramuscular diclofenac compared to intravenous tramadol for acute renal colic in northern Thai patients: A randomised double-blind, sham-controlled trial.
Emerg Med Australas
February 2025
Gifted Mathematics Program, Montfort College, Chiang Mai, Thailand.
Objective: The present study aimed to compare time to effective pain relief between diclofenac 75 mg intramuscular (IM) and tramadol 50 mg intravenous (IV) for ED patients with acute renal colic.
Methods: A randomised, double-blinded, sham-controlled, superiority trial was conducted. Patients diagnosed with acute renal colic (hydronephrosis and/or stone visualisation on point-of-care ultrasound) in the ED were randomly assigned to receive an IM injection of 75 mg of diclofenac or IV tramadol 50 mg.
Association between the changes in the estimated glucose disposal rate and new-onset cardiovascular disease in middle-aged and elderly individuals: A nationwide prospective cohort study in China.
Diabetes Obes Metab
January 2025
Department of Hypertension and Vascular Disease, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Aims: Previous studies have shown that eGDR and TyG, as indicators of insulin resistance (IR), were key risk factors for cardiovascular disease (CVD). Our study further explored the relationship between eGDR change and new-onset CVD, and compared the predictive value of eGDR change, eGDR and TyG.
Materials And Methods: A total of 2895 participants without CVD at baseline from the China Health and Retirement Longitudinal Study (CHARLS) were included, using K-means clustering and cumulative eGDR to measure eGDR change between 2012 and 2015.
Joint association of triglyceride glucose index (TyG) and a body shape index (ABSI) with stroke incidence: a nationwide prospective cohort study.
Cardiovasc Diabetol
January 2025
Department of Neurology, the First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China.
Background: Triglyceride glucose index(TyG) and a body shape index(ABSI) are both independent predictor of stroke incidence or adverse prognosis but these two indicators seldom were combined to predict. The purpose of this study is to evaluate whether the combination of TyG and ABSI better predict the incidence of stroke.
Methods: Based on the China Health and Retirement Longitudinal Study(CHARLS), 8,257 people aged 45 years and older without stroke were enrolled and followed up to 9 years.
Detection rate and clinical characteristics of coexisting autoimmune diseases in children with Graves' disease: a single-center study from China.
Endocrine
January 2025
Department of Endocrinology, Genetics and Metabolism, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
Purpose: This study aimed to determine the detection rate of autoimmune polyendocrine syndrome (APS) among children with Graves' disease (GD) at a single center and to compare clinical characteristics between those with isolated GD and those GD with APS (APS-GD).
Methods: A retrospective analysis was conducted on the clinical data of 555 patients and were categorized into isolated GD and APS-GD groups based on their progression status. The time for FT to return to normal was used as an indicator of short-term treatment effectiveness.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!