Caspian Journal of Internal Medicine
Babol University of Medical Sciences
یکشنبه 15 شهریور 1405
[Archive]
دوره 17، شماره 3 - ( 4-1405 )
جلد 17 شماره 3 صفحات 561-555 |
برگشت به فهرست نسخه ها
Ethics code: IR.MUBABOL.REC.1401.095
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Hamidian M, Shokryshirvany J, Rajabi Fomashi M, Bijani A, Abedi Valoukolaei S H. When to wait and when to intervene: A retrospective study on predicting spontaneous clearance of common bile duct stones in ERCP candidates. Caspian J Intern Med 2026; 17 (3) :555-561
URL: http://caspjim.com/article-1-4838-fa.html
URL: http://caspjim.com/article-1-4838-fa.html
When to wait and when to intervene: A retrospective study on predicting spontaneous clearance of common bile duct stones in ERCP candidates. . 1405; 17 (3) :555-561
چکیده: (10 مشاهده)
Background: While ERCP is a cornerstone in the management of choledocholithiasis, a significant proportion of common bile duct (CBD) stones may clear spontaneously, prompting the need for better risk stratification. To identify independent clinical, biochemical, and radiologic predictors of spontaneous CBD stone clearance in patients referred for ERCP.
Methods: In this retrospective study, 324 patients with suspected choledocholithiasis were evaluated. Demographics, symptoms, laboratory values, imaging findings, and ERCP outcomes were analyzed. Multivariable logistic regression was employed to identify predictors of spontaneous stone passage, defined as the absence of CBD stones during ERCP despite prior radiologic or biochemical suspicion.
Results: Spontaneous clearance occurred in 41.4% of patients. Multivariate analysis revealed that male sex (OR = 2.1; 95% CI: 1.3–3.4), CBD diameter ≥7 mm (OR = 2.9; 95% CI: 1.7–5.0), and normalization of liver enzymes prior to ERCP (OR = 1.8; 95% CI: 1.1–3.0) were significant independent predictors. Stone size, number, and comorbidities were not statistically significant in predicting clearance.
Conclusion: A combination of male sex, CBD dilation, and biochemical normalization strongly predicts spontaneous CBD stone clearance. Incorporating these variables into clinical decision-making may help avoid unnecessary ERCPs, reducing patient risk and enhancing procedural efficiency. Prospective validation of these predictors is warranted to develop evidence-based risk models.
Methods: In this retrospective study, 324 patients with suspected choledocholithiasis were evaluated. Demographics, symptoms, laboratory values, imaging findings, and ERCP outcomes were analyzed. Multivariable logistic regression was employed to identify predictors of spontaneous stone passage, defined as the absence of CBD stones during ERCP despite prior radiologic or biochemical suspicion.
Results: Spontaneous clearance occurred in 41.4% of patients. Multivariate analysis revealed that male sex (OR = 2.1; 95% CI: 1.3–3.4), CBD diameter ≥7 mm (OR = 2.9; 95% CI: 1.7–5.0), and normalization of liver enzymes prior to ERCP (OR = 1.8; 95% CI: 1.1–3.0) were significant independent predictors. Stone size, number, and comorbidities were not statistically significant in predicting clearance.
Conclusion: A combination of male sex, CBD dilation, and biochemical normalization strongly predicts spontaneous CBD stone clearance. Incorporating these variables into clinical decision-making may help avoid unnecessary ERCPs, reducing patient risk and enhancing procedural efficiency. Prospective validation of these predictors is warranted to develop evidence-based risk models.
نوع مطالعه: Original Article |
موضوع مقاله:
Gastroentrology
دریافت: 1404/4/27 | پذیرش: 1404/8/5 | انتشار: 1405/3/19
دریافت: 1404/4/27 | پذیرش: 1404/8/5 | انتشار: 1405/3/19
| بازنشر اطلاعات | |
 |
این مقاله تحت شرایط Creative Commons Attribution-NonCommercial 4.0 International License قابل بازنشر است. |
