Nikhil Panda1, Yuchiao Chang2, Nalin Chokengarmwong2, Myriam Martinez3, Liyang Yu2, Peter J Fagenholz3, Haytham A Kaafarani3, David R King3, Marc A DeMoya3, George C Velmahos3, D Dante Yeh4. 1. Division of Trauma and Acute Care Surgery, Department of Surgery, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA. nikhil.panda@mgh.harvard.edu. 2. Department of Medicine, Massachusetts General Hospital, 55 Fruit Street, GRB-425, Boston, MA, 02114, USA. 3. Division of Trauma and Acute Care Surgery, Department of Surgery, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA. 4. Division of Trauma and Surgical Critical Care, University of Miami, 1800 N.W. 10th Ave, Miami, FL, 33136, USA.
Abstract
BACKGROUND: Patients with gallstone pancreatitis (GP) or choledocholithiasis (CDL) may have common bile duct (CBD) stones that persist until cholangiography. The aim of this study is to evaluate pre-cholangiogram factors that predict persistent CBD stones. METHODS: Multiple logistic regression analyses were performed to identify demographic, laboratory, and radiologic predictors of persistent CBD stones and non-therapeutic cholangiography among adults with GP or CDL. RESULTS: In 152 patients from 2010 to 2015, preoperative diagnosis, presence of a CBD stone on US, and age ≥ 60 years were associated with persistent CBD stones. Two risk factors alone had a PPV of 88% and the absence of all risk factors had a NPV of 94%. Age < 60 years and the absence of a CBD stone on US were most predictive of non-therapeutic cholangiography. CONCLUSION: Age, LFTs, and US help predict persistent CBD stones in patients initially presenting with GP or CDL and help minimize non-therapeutic preoperative cholangiography.
BACKGROUND:Patients with gallstone pancreatitis (GP) or choledocholithiasis (CDL) may have common bile duct (CBD) stones that persist until cholangiography. The aim of this study is to evaluate pre-cholangiogram factors that predict persistent CBD stones. METHODS: Multiple logistic regression analyses were performed to identify demographic, laboratory, and radiologic predictors of persistent CBD stones and non-therapeutic cholangiography among adults with GP or CDL. RESULTS: In 152 patients from 2010 to 2015, preoperative diagnosis, presence of a CBD stone on US, and age ≥ 60 years were associated with persistent CBD stones. Two risk factors alone had a PPV of 88% and the absence of all risk factors had a NPV of 94%. Age < 60 years and the absence of a CBD stone on US were most predictive of non-therapeutic cholangiography. CONCLUSION: Age, LFTs, and US help predict persistent CBD stones in patients initially presenting with GP or CDL and help minimize non-therapeutic preoperative cholangiography.
Authors: John T Maple; Tamir Ben-Menachem; Michelle A Anderson; Vasundhara Appalaneni; Subhas Banerjee; Brooks D Cash; Laurel Fisher; M Edwyn Harrison; Robert D Fanelli; Norio Fukami; Steven O Ikenberry; Rajeev Jain; Khalid Khan; Mary Lee Krinsky; Laura Strohmeyer; Jason A Dominitz Journal: Gastrointest Endosc Date: 2010-01 Impact factor: 9.427
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Authors: Yang Lei; B Cord Lethebe; Erin Wishart; Fateh Bazerbachi; B Joseph Elmunzer; Nirav Thosani; James L Buxbaum; Yen-I Chen; Sydney Bass; Martin J Cole; Christian Turbide; Darren R Brenner; Steven J Heitman; Rachid Mohamed; Nauzer Forbes Journal: J Clin Med Date: 2022-08-05 Impact factor: 4.964