Evidence map›Paper›PMID 34494152›Full record

ArticleSurgical endoscopy2022

The high rate of spontaneous migration of small size common bile duct stones may allow a significant reduction in unnecessary ERCP and related complications: results of a retrospective, multicenter study.

Paolo Andreozzi, Germana de Nucci, Massimo Devani, Davide Redaelli, Mario Schettino, Donato Iuliano, Claudio Zulli, Attilio Maurano, Maria Erminia Bottiglieri, Gregorios Paspatis and 2 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.9field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 12 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 4 institutions in 2 countries.

Paolo AndreozziGastroenterology and Endoscopy Unit, ASL Caserta, Marcianise Hospital, Marcianise, Caserta, Italy.
Germana de NucciDepartment of Gastroenterology, ASST Rhodense, Rho and Garbagnate M.se Hospitals, Viale Forlanini 95, Garbagnate Milanese, Milan, Italy.
Massimo DevaniDepartment of Gastroenterology, ASST Rhodense, Rho and Garbagnate M.se Hospitals, Viale Forlanini 95, Garbagnate Milanese, Milan, Italy.
Davide RedaelliDepartment of Gastroenterology, ASST Rhodense, Rho and Garbagnate M.se Hospitals, Viale Forlanini 95, Garbagnate Milanese, Milan, Italy.
Mario SchettinoDepartment of Gastroenterology, ASST Rhodense, Rho and Garbagnate M.se Hospitals, Viale Forlanini 95, Garbagnate Milanese, Milan, Italy.
Donato IulianoGastroenterology and Endoscopy Unit, ASL Caserta, Marcianise Hospital, Marcianise, Caserta, Italy.
Claudio ZulliEndoscopic Unit of Fucito Hospital, University Hospital of Salerno, Salerno, Italy.
Attilio MauranoEndoscopic Unit of Fucito Hospital, University Hospital of Salerno, Salerno, Italy.
Maria Erminia BottiglieriGastroenterology and Endoscopy Unit, ASL Caserta, Marcianise Hospital, Marcianise, Caserta, Italy.
Gregorios PaspatisGastroenterology Department, Benizelion General Hospital, Heraklion, Crete, Greece.
Marco DinelliGastroenterology and Endoscopy Unit, San Gerardo Hospital, Monza, Italy.
Gianpiero ManesDepartment of Gastroenterology, ASST Rhodense, Rho and Garbagnate M.se Hospitals, Viale Forlanini 95, Garbagnate Milanese, Milan, Italy. gimanes@tin.it.
Aziende Socio Sanitaria Territoriale RhodenseUniversity of Salerno · ITAzienda Ospedaliera San Gerardo · ITThe General Hospital of Heraklion "Venizeleio-Pananio" · GR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionCommon bile duct stones (CBDS) can spontaneously migrate through the duodenal papilla. In this case, ERCP could be unnecessary and a significant rate of complications could be avoided. In this study, we aim at retrospectively evaluating the rate of spontaneous stone passage in patients with an imaging diagnosis of CBDS and at analysing the factors associated to spontaneous stone migration.

methodsWe conducted a retrospective multi-centre analysis of patients undergoing ERCP for CBDS in a 12-month period. 1016 patients with CBDS were analysed. In all patients CBDS was diagnosed with adequate imaging methods performed prior to ERCP. ERCPs with failed biliary cannulation were excluded. Data regarding patients' characteristics, imaging findings and ERCP procedure were analysed.

results1016 patients with CBDS undergoing ERCP were analysed (male sex 43.3%; mean age 69.9 ± 16.5 years). Diagnosis of CBDS was obtained by EUS in 415 patients (40.8%), MR in 343 (33.8%), CT in 220 (21.7%), and US in 38 (3.7%). No stones were found at ERCP in 179 patients (17.6%), in 14 (6.2%) when ERCP was performed within 6 h from imaging study, in 114 (18.5%) between 7 h and 7 days, in 32 (24.6%) between 8 and 29 days, and in 19 (43.2%) after 30 days. The rate of unnecessary ERCP occurred significantly more frequently in patients in whom imaging methods demonstrated either sludge or ≤ 5 mm CBDS (29.9 vs. 8.3%; p < 0.001). DISCUSSION: Spontaneous migration of small CBDS is a frequent event, and ≤ 5 mm size and a delay in ERCP > 7 days represent predictive factors for it. We suggest that CBDS ≤ 5 mm should not undergo immediate removal and this fact would allow reducing the rate of unnecessary ERCP with their related complications. Prospective studies are needed to confirm these results and demonstrate the safety of a conservative management in this setting.

Indexed as

Cholangiopancreatography, Endoscopic RetrogradeGallstonesAgedAged, 80 and overCommon Bile DuctHumansMaleMiddle AgedProspective StudiesRetrospective StudiesCommon bile duct stonesComplicationsERCPImaging

Identifiers

PMID34494152
OpenAlexW3198854464

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.