Parameters Suggesting Spontaneous Passage of Stones from Common Bile Duct: A Retrospective Study
Background. Common bile duct (CBD) stones are common. However, they are known to pass spontaneously, which obviates the need for ERCP. Aim. The aim of this study is to identify specific predictors for spontaneous passage of CBD stones. Methods. Data was retrospectively collected for all patients who...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Canadian Journal of Gastroenterology and Hepatology |
| Online Access: | http://dx.doi.org/10.1155/2019/5382708 |
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| author | Tawfik Khoury Mohamed Adileh Ashraf Imam Yosef Azraq Avital Bilitzky-Kopit Muhamad Massarwa Ari Benson Zaher Bahouth Samir Abu-Gazaleh Wisam Sbeit Rifaat Safadi Abed Khalaileh |
| author_facet | Tawfik Khoury Mohamed Adileh Ashraf Imam Yosef Azraq Avital Bilitzky-Kopit Muhamad Massarwa Ari Benson Zaher Bahouth Samir Abu-Gazaleh Wisam Sbeit Rifaat Safadi Abed Khalaileh |
| author_sort | Tawfik Khoury |
| collection | DOAJ |
| description | Background. Common bile duct (CBD) stones are common. However, they are known to pass spontaneously, which obviates the need for ERCP. Aim. The aim of this study is to identify specific predictors for spontaneous passage of CBD stones. Methods. Data was retrospectively collected for all patients who were hospitalized with clinical, laboratory, or ultrasonographic evidence of choledocholithiasis and who underwent magnetic resonance cholangiopancreatography (MRCP) in Hadassah Medical Center between 2005 and 2011. The patients were classified into 4 groups: group A (positive MRCP and positive ERCP), group B (positive MRCP but negative ERCP), group C (positive MRCP but did not undergo ERCP), and group D (negative MRCP that did not undergo ERCP) for choledocholithiasis. All positive MRCP-groups (A+B+C) were further grouped together into group E. We compared groups A versus B and groups E versus D. Results. Comparing groups A versus B, only gamma-glutamyl transferase predicted spontaneous passage of stones from CBD, as the level was significantly higher in group A (677±12.1) versus group B (362.4±216.2) (P=0.023). Patients with small stone diameter (P=0.001), distal stones (P=0.05), and absence of intrahepatic dilatation (P=0.047) tend to pass their stones spontaneously. Comparing groups D versus E, it was found that male gender (P=0.03), older age (P<0.001), high levels of GGT (P=0.022), high levels of alkaline phosphatase (P=0.011), high levels of total bilirubin (P=0.007), and lower levels of amylase (P<0.001) are predictors for positive MRCP studies for CBD stones. Conclusion. Identification of specific predictors is important to avoid unnecessary invasive endoscopic intervention. |
| format | Article |
| id | doaj-art-d45e4d7d5ec14ac884be21485124d68d |
| institution | Kabale University |
| issn | 2291-2789 2291-2797 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
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| series | Canadian Journal of Gastroenterology and Hepatology |
| spelling | doaj-art-d45e4d7d5ec14ac884be21485124d68d2025-02-03T01:10:47ZengWileyCanadian Journal of Gastroenterology and Hepatology2291-27892291-27972019-01-01201910.1155/2019/53827085382708Parameters Suggesting Spontaneous Passage of Stones from Common Bile Duct: A Retrospective StudyTawfik Khoury0Mohamed Adileh1Ashraf Imam2Yosef Azraq3Avital Bilitzky-Kopit4Muhamad Massarwa5Ari Benson6Zaher Bahouth7Samir Abu-Gazaleh8Wisam Sbeit9Rifaat Safadi10Abed Khalaileh11Department of Gastroenterology and Liver Disease, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, IsraelDepartment of Surgery, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, IsraelDepartment of Surgery, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, IsraelDepartment of Radiology, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, IsraelDepartment of Surgery, Kaplan Medical Center, Rehovot, IsraelDepartment of Gastroenterology and Liver Disease, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, IsraelDepartment of Gastroenterology and Liver Disease, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, IsraelDepartment of Surgery, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, IsraelDepartment of Surgery, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, IsraelInstitute of Gastroenterology and Liver Diseases, Galilee Medical Center, Bar Ilan Faculty of Medicine, IsraelDepartment of Gastroenterology and Liver Disease, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, IsraelDepartment of Surgery, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, IsraelBackground. Common bile duct (CBD) stones are common. However, they are known to pass spontaneously, which obviates the need for ERCP. Aim. The aim of this study is to identify specific predictors for spontaneous passage of CBD stones. Methods. Data was retrospectively collected for all patients who were hospitalized with clinical, laboratory, or ultrasonographic evidence of choledocholithiasis and who underwent magnetic resonance cholangiopancreatography (MRCP) in Hadassah Medical Center between 2005 and 2011. The patients were classified into 4 groups: group A (positive MRCP and positive ERCP), group B (positive MRCP but negative ERCP), group C (positive MRCP but did not undergo ERCP), and group D (negative MRCP that did not undergo ERCP) for choledocholithiasis. All positive MRCP-groups (A+B+C) were further grouped together into group E. We compared groups A versus B and groups E versus D. Results. Comparing groups A versus B, only gamma-glutamyl transferase predicted spontaneous passage of stones from CBD, as the level was significantly higher in group A (677±12.1) versus group B (362.4±216.2) (P=0.023). Patients with small stone diameter (P=0.001), distal stones (P=0.05), and absence of intrahepatic dilatation (P=0.047) tend to pass their stones spontaneously. Comparing groups D versus E, it was found that male gender (P=0.03), older age (P<0.001), high levels of GGT (P=0.022), high levels of alkaline phosphatase (P=0.011), high levels of total bilirubin (P=0.007), and lower levels of amylase (P<0.001) are predictors for positive MRCP studies for CBD stones. Conclusion. Identification of specific predictors is important to avoid unnecessary invasive endoscopic intervention.http://dx.doi.org/10.1155/2019/5382708 |
| spellingShingle | Tawfik Khoury Mohamed Adileh Ashraf Imam Yosef Azraq Avital Bilitzky-Kopit Muhamad Massarwa Ari Benson Zaher Bahouth Samir Abu-Gazaleh Wisam Sbeit Rifaat Safadi Abed Khalaileh Parameters Suggesting Spontaneous Passage of Stones from Common Bile Duct: A Retrospective Study Canadian Journal of Gastroenterology and Hepatology |
| title | Parameters Suggesting Spontaneous Passage of Stones from Common Bile Duct: A Retrospective Study |
| title_full | Parameters Suggesting Spontaneous Passage of Stones from Common Bile Duct: A Retrospective Study |
| title_fullStr | Parameters Suggesting Spontaneous Passage of Stones from Common Bile Duct: A Retrospective Study |
| title_full_unstemmed | Parameters Suggesting Spontaneous Passage of Stones from Common Bile Duct: A Retrospective Study |
| title_short | Parameters Suggesting Spontaneous Passage of Stones from Common Bile Duct: A Retrospective Study |
| title_sort | parameters suggesting spontaneous passage of stones from common bile duct a retrospective study |
| url | http://dx.doi.org/10.1155/2019/5382708 |
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