Predictive factors for spontaneous passage of common bile duct stones through the duodenal papilla
10.3760/cma.j.cn321463-20241215-00293
- VernacularTitle:胆总管结石经十二指肠乳头自行排石的预测因素分析
- Author:
Guangzhong YUAN
1
;
Hanying WANG
1
;
Lijuan MAO
1
;
Renhu SUN
1
;
Dapeng WU
1
;
Qide ZHANG
1
;
Tingsheng LING
1
;
Hailin JIN
1
Author Information
1. 南京中医药大学附属医院 江苏省中医院消化内镜中心，南京 210029
- Publication Type:Journal Article
- Keywords:
Cholangiopancreatography, endoscopic retrograde;
Choledocholithiasis;
Spontaneous passage;
Predictive factors
- From:
Chinese Journal of Digestive Endoscopy
2025;42(10):796-802
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical characteristics and identify predictive factors for spontaneous passage of common bile duct (CBD) stones.Methods:A retrospective analysis was conducted on patients diagnosed as having choledocholithiasis via abdominal imaging at outpatient and emergency departments of Jiangsu Province Hospital of Chinese Medicine and other medical institutions from January 2021 to November 2023. Participants were stratified into spontaneous passage versus non-passage groups. Multivariate logistic regression analysis was used to identify predictors for the spontaneous passage of common bile duct stones.Results:Spontaneous stone passage were confirmed in 70 cases (15.5%). Multivariate logistic regression analysis identified that an admission diagnosis of acute biliary pancreatitis ( OR=3.317, 95% CI: 1.427-7.713, P=0.005), larger common bile duct diameter ( OR=1.117, 95% CI: 1.000-1.248, P=0.049), and solitary stones ( OR=11.135, 95% CI: 3.602-34.418, P<0.001) significantly increased the probability of spontaneous stones. In contrast, larger stone long diameter ( OR=0.539, 95% CI: 0.441-0.659, P<0.001) markedly decreased passage likelihood. Receiver operator characteristic (ROC) curve analysis demonstrated that the common bile duct diameter predicted spontaneous stone passage with an area under the curve (AUC) of 0.662, yielding sensitivity of 52.9% (37/70) and specificity of 73.6% (51/70) at a cutoff value of 9.5 mm. The common bile duct stone diameter achieved an AUC of 0.852 for predicting spontaneous stone passage, with sensitivity of 75.7% (53/70) and specificity of 89.0% (62/70) at a cutoff value of 4.5 mm. Conclusion:Solitary small stones, ductal dilation, and an admission diagnosis of acute biliary pancreatitis are key predictive factors for spontaneous common bile duct stone passage. A common bile duct diameter ≥9.5 mm and stone long diameter ≤4.5 mm are more likely to result in spontaneous stone passage.
