On Factors Related to Spontaneous Passage of Common Bile Duct Stones Leading to Unnecessary Endoscopic Retrograde Cholangiopancreatography
10.3969/j.issn.1009-6604.2024.06.002
- VernacularTitle:胆总管结石自然排石致非必要治疗性内镜下逆行胰胆管造影的影响因素
- Author:
Lei JIANG
1
;
Zhen LIU
;
Jianfeng YU
;
Xinjuan LIU
Author Information
1. 首都医科大学附属北京朝阳医院消化内科,北京 100020
- Keywords:
Common bile duct stones;
Endoscopic retrograde cholangiopancreatography;
Spontaneous passage
- From:
Chinese Journal of Minimally Invasive Surgery
2024;24(6):409-414
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate influential factors of spontaneous passage of common bile duct stones(CBDS)leading to unnecessary endoscopic retrograde cholangiopancreatography(ERCP).Methods We retrieved 432 cases undergoing ERCP for CBDS from January 2023 to February 2024 through our hospital's electronic medical record system.After screening according to exclusion criteria,a total of 393 cases were included.According to the presence or absence of CBDS during ERCP,they were divided into two groups:the spontaneous stone passage group and the confirmed CBDS group.We evaluated 26 variables to determine influential factors of spontaneous stone passage through both univariate and multivariate analyses.Results Out of the 393 patients[42.7％female(168/393);mean age,63.9 years old],stones were not found in 76 patients(19.3％)during the ERCP procedure.After excluding 2 false positives,74 case were included in the spontaneous stone passage group and 317 case in the confirmed CBDS group.In univariate analysis,7 factors were found potentially associated with spontaneous passage(P＜0.05),including age,vomiting,elevation of asperate aminotransferase,elevation of blood amylase,common bile duct dilation,diameter of CBDS ≤5 mm,and single CBDS.Significant associations with spontaneous CBDS passage were identified as vomiting(OR=3.432,95％CI:1.271-9.272,P=0.015)and diameter of CBDS ≤ 5 mm(OR=4.835,95％CI:2.720-8.595,P=0.000)in multivariate analyses.Conclusions Spontaneous CBDS passage occurs more frequently in patients with small stones(≤5 mm)and presence of vomiting.For patients with such characteristics,clinical physicians should consider the patient's situation and,if necessary,review endoscopic ultrasound or magnetic resonance cholangiopancreatography before ERCP for avoiding unnecessary ERCP.
