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J Gastroenterol Hepatol. 2019 Jul 23. doi: 10.1111/jgh.14790. [Epub ahead of print]

Endoscopic treatment for choledocholithiasis in asymptomatic patients.

Author information

1
Department of Gastroenterology, Changshu No.1 People's Hospital, Changshu Affiliated Hospital of Soochow University, Changshu, China.
2
Department of Gastroenterology, Zhangjiagang Aoyang Hospital, Zhangjiagang, China.

Abstract

BACKGROUND AND AIM:

A few small retrospective studies recently found that endoscopic retrograde cholangiopancreatography (ERCP) in asymptomatic compared with symptomatic common bile duct stones (CBDSs) patients appeared to increase the risk of post-ERCP pancreatitis (PEP). This study aimed to determine the risk of ERCP in asymptomatic CBDS patients.

METHODS:

A total of 327 consecutive patients with native papilla were invited to participate into the study and divided into two groups: 53 in the asymptomatic group and 274 in the symptomatic group, who underwent CBDS removal by ERCP. Patient's characteristics and outcomes were analyzed.

RESULTS:

A total of 46 (14.1%) patients had ERCP-related complications, including PEP, cholangitis, perforation, and bleeding. The overall complication rate in the asymptomatic group was higher than in the control group (26.4% vs 11.7%, P < 0.01). PEP was the most common complication (30/327, 9.2%). Of the 30 cases of PEP, 25 (83.3%) were mild, and the severity in both groups was similar (9/1/1 vs 16/2/1, P > 0.05). The incidence rate of PEP in the asymptomatic group was higher than in the symptomatic group (20.8% vs 6.9%, P < 0.01). Multivariate regression analysis identified asymptomatic CBDSs (odds ratio = 0.241, 95% confidence interval: 0.092-0.628) as being independently associated with PEP occurrence.

CONCLUSION:

Asymptomatic CBDSs were associated with increased incidence of PEP compared with symptomatic CBDSs.

KEYWORDS:

endoscopic retrograde cholangiopancreatography; gallstone disease; pancreas

PMID:
31334888
DOI:
10.1111/jgh.14790

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