Predictive factors of spontaneous common bile duct clearance and unnecessary ERCP in patients with choledocholithiasis

Bibliographic Details
Main Author: Correia, Fábio Pereira
Publication Date: 2024
Other Authors: Coelho, Henrique, Francisco, Mónica, Alexandrino, Gonçalo, Branco, Joana Carvalho, Canena, Jorge, Horta, David, Lourenço, Luís Carvalho
Format: Article
Language: eng
Source: Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
Download full: http://hdl.handle.net/10362/176796
Summary: Publisher Copyright: © 2024
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spelling Predictive factors of spontaneous common bile duct clearance and unnecessary ERCP in patients with choledocholithiasisCholedocholithiasisEndoscopic ultrasoundPredictive factorsUnnecessary ERCPGastroenterologyPublisher Copyright: © 2024Background: Endoscopic retrograde cholangiopancreatography (ERCP) is the first-line procedure for choledocholithiasis treatment. However, it is associated with a 10 % rate of adverse events. Spontaneous migration of common bile duct (CBD) stones occurs in 6–33 % of choledocholithiasis cases, making ERCP avoidable. This study aimed to identify predictors of spontaneous CBD stones’ migration. Methods: Retrospective study including patients diagnosed with choledocholithiasis and submitted to ERCP. Patients were divided into 2 groups considering spontaneous stone migration (i.e.: the absence of CBD stones on ERCP). Data on patients’ characteristics, imaging findings, biochemical analysis, and ERCP procedure were analyzed to identify predictors of spontaneous migration of CBD stones. Results: 334 patients with a mean age of 71.7 years were included in the study: 76.6 % without and 23.4 % with spontaneous migration of CBD stones. Although some patients’ features (gender and clinical presentation), imaging findings (diameters of the largest stone and CBD), biochemical analysis (bilirubin levels at diagnosis and pre-ERCP), and ERCP procedure characteristics (time from diagnosis to ERCP) were different between groups, only three variables were defined as predictors: the absence of acute cholangitis, the largest stone diameter ≤5 mm, and the bilirubin levels pre-ERCP ≤ 2mg/dL. When using those variables together there was a chance of 81–86 % to correctly distinguishing patients with and without spontaneous CBD stone migration. Conclusion: The size of the largest stone at diagnosis was validated as a predictor of CBD stones’ spontaneous migration. Furthermore, two new predictors were identified: bilirubin levels pre-ERCP ≤ 2 mg/dL, and no acute cholangitis at the clinical presentation of choledocholithiasis. EUS and ERCP in the same session should be considered in patients with factors predictive of stone migration, especially when combined, to minimize unnecessary ERCP and possible complications.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)RUNCorreia, Fábio PereiraCoelho, HenriqueFrancisco, MónicaAlexandrino, GonçaloBranco, Joana CarvalhoCanena, JorgeHorta, DavidLourenço, Luís Carvalho2024-12-27T21:31:41Z2025-012025-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/176796eng2210-7401PURE: 105300634https://doi.org/10.1016/j.clinre.2024.102515info:eu-repo/semantics/openAccessreponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiainstacron:RCAAP2025-01-13T01:44:04Zoai:run.unl.pt:10362/176796Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireinfo@rcaap.ptopendoar:https://opendoar.ac.uk/repository/71602025-05-28T19:20:35.604969Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologiafalse
dc.title.none.fl_str_mv Predictive factors of spontaneous common bile duct clearance and unnecessary ERCP in patients with choledocholithiasis
title Predictive factors of spontaneous common bile duct clearance and unnecessary ERCP in patients with choledocholithiasis
spellingShingle Predictive factors of spontaneous common bile duct clearance and unnecessary ERCP in patients with choledocholithiasis
Correia, Fábio Pereira
Choledocholithiasis
Endoscopic ultrasound
Predictive factors
Unnecessary ERCP
Gastroenterology
title_short Predictive factors of spontaneous common bile duct clearance and unnecessary ERCP in patients with choledocholithiasis
title_full Predictive factors of spontaneous common bile duct clearance and unnecessary ERCP in patients with choledocholithiasis
title_fullStr Predictive factors of spontaneous common bile duct clearance and unnecessary ERCP in patients with choledocholithiasis
title_full_unstemmed Predictive factors of spontaneous common bile duct clearance and unnecessary ERCP in patients with choledocholithiasis
title_sort Predictive factors of spontaneous common bile duct clearance and unnecessary ERCP in patients with choledocholithiasis
author Correia, Fábio Pereira
author_facet Correia, Fábio Pereira
Coelho, Henrique
Francisco, Mónica
Alexandrino, Gonçalo
Branco, Joana Carvalho
Canena, Jorge
Horta, David
Lourenço, Luís Carvalho
author_role author
author2 Coelho, Henrique
Francisco, Mónica
Alexandrino, Gonçalo
Branco, Joana Carvalho
Canena, Jorge
Horta, David
Lourenço, Luís Carvalho
author2_role author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
RUN
dc.contributor.author.fl_str_mv Correia, Fábio Pereira
Coelho, Henrique
Francisco, Mónica
Alexandrino, Gonçalo
Branco, Joana Carvalho
Canena, Jorge
Horta, David
Lourenço, Luís Carvalho
dc.subject.por.fl_str_mv Choledocholithiasis
Endoscopic ultrasound
Predictive factors
Unnecessary ERCP
Gastroenterology
topic Choledocholithiasis
Endoscopic ultrasound
Predictive factors
Unnecessary ERCP
Gastroenterology
description Publisher Copyright: © 2024
publishDate 2024
dc.date.none.fl_str_mv 2024-12-27T21:31:41Z
2025-01
2025-01-01T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10362/176796
url http://hdl.handle.net/10362/176796
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 2210-7401
PURE: 105300634
https://doi.org/10.1016/j.clinre.2024.102515
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
instname:FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
instacron:RCAAP
instname_str FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
instacron_str RCAAP
institution RCAAP
reponame_str Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
collection Repositórios Científicos de Acesso Aberto de Portugal (RCAAP)
repository.name.fl_str_mv Repositórios Científicos de Acesso Aberto de Portugal (RCAAP) - FCCN, serviços digitais da FCT – Fundação para a Ciência e a Tecnologia
repository.mail.fl_str_mv info@rcaap.pt
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