İnan Bayram, Akbay Ahmet, Güven İbrahim Ethem, Ersoy Osman
Department of Gastroenterology, Ankara City Hospital, Bilkent, Ankara 06800, Turkey.
Departmant of Gastroenterology, Ankara Yildirim Beyazit University Yenimahalle Training and Research Hospital, Ankara 06370, Turkey.
J Clin Med. 2024 May 2;13(9):2672. doi: 10.3390/jcm13092672.
Common bile duct (CBD) stones may pass spontaneously without any intervention. Assessment of the predictors of spontaneous passage can contribute to avoiding unnecessary endoscopic retrograde cholangiopancreatography (ERCP) implementation. This study aimed to investigate the factors related to spontaneous passage of CBD stones. From January 2021 to August 2023, patients with naïve papilla who had undergone biliary ERCP and with CBD stones detected by MRCP before the procedure were analyzed retrospectively. Subjects were divided into two groups on the basis of the presence of stones during the ERCP procedure: the spontaneous passage group and the non-passage group. Groups were compared in terms of demographic, laboratory, and radiological data. A total of 236 patients, including 26 in the spontaneous passage group and 210 in the non-passage group, were involved. Multivariate logistic regression analyses revealed that only stone size was significantly associated with spontaneous passage. From ROC curve analysis, stone size with a cut-off value of 4.3 mm predicted spontaneous passage with 58% sensitivity and 85% specificity. Stones with a size of less than 4.3 mm are more likely to pass spontaneously without endoscopic intervention. Paying attention to the stone diameter before ERCP procedures can contribute to avoiding unnecessary ERCP implementation.
胆总管（CBD）结石可能会在没有任何干预的情况下自行排出。评估结石自行排出的预测因素有助于避免不必要的内镜逆行胰胆管造影（ERCP）操作。本研究旨在探讨与CBD结石自行排出相关的因素。回顾性分析了2021年1月至2023年8月期间，接受初次乳头手术且在术前通过磁共振胰胆管造影（MRCP）检测出CBD结石的患者。根据ERCP手术过程中结石的存在情况，将研究对象分为两组：自行排出组和未排出组。比较两组的人口统计学、实验室检查和影像学数据。本研究共纳入236例患者，其中自行排出组26例，未排出组210例。多因素logistic回归分析显示，只有结石大小与结石自行排出显著相关。通过ROC曲线分析，结石大小截断值为4.3 mm时，预测结石自行排出的灵敏度为58%，特异度为85%。直径小于4.3 mm的结石更有可能在无内镜干预的情况下自行排出。在ERCP手术前关注结石直径有助于避免不必要的ERCP操作。
