Evidence map›Paper›PMID 36849567›Full record

ArticleSurgical endoscopy2023

Unnecessary endoscopic retrograde cholangiopancreatography associated with the spontaneous passage of common bile duct stones into the duodenum: a multicenter retrospective study.

Hirokazu Saito, Hajime Iwasaki, Hisashi Itoshima, Yoshihiro Kadono, Takashi Shono, Kentaro Kamikawa, Masayoshi Uehara, Atsushi Urata, Jiro Nasu, Ikuo Matsushita and 2 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2023. 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
–field-weighted citation impact
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.

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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.

Hirokazu SaitoDepartment of Gastroenterology, Kumamoto City Hospital, 4-1-60, Higashimachi, Higashi-Ku, Kumamoto, 862-8505, Japan. arnestwest@yahoo.co.jp.ORCID 0000-0001-8729-9604
Hajime IwasakiDepartment of Gastroenterology, Kumamoto Chuo Hospital, 1-5-1, Tainoshima, Minami-Ku, Kumamoto, 862-0965, Japan.
Hisashi ItoshimaDepartment of Gastroenterology, Saiseikai Kumamoto Hospital, 5-3-1, Chikami, Minami-Ku, Kumamoto, 861-4193, Japan.
Yoshihiro KadonoDepartment of Gastroenterology, Tsuruta Hospital, 10-112, Hotakubohonmachi, Higashi-Ku, Kumamoto, 862-0925, Japan.
Takashi ShonoDepartment of Gastroenterology, Kumamoto Chuo Hospital, 1-5-1, Tainoshima, Minami-Ku, Kumamoto, 862-0965, Japan.
Kentaro KamikawaDepartment of Gastroenterology, Saiseikai Kumamoto Hospital, 5-3-1, Chikami, Minami-Ku, Kumamoto, 861-4193, Japan.
Masayoshi UeharaDepartment of Gastroenterology, Saiseikai Kumamoto Hospital, 5-3-1, Chikami, Minami-Ku, Kumamoto, 861-4193, Japan.
Atsushi UrataDepartment of Gastroenterology, Saiseikai Kumamoto Hospital, 5-3-1, Chikami, Minami-Ku, Kumamoto, 861-4193, Japan.
Jiro NasuDepartment of Gastroenterological Surgery, Kumamoto Chuo Hospital, 1-5-1, Tainoshima, Minami-Ku, Kumamoto, 862-0965, Japan.
Ikuo MatsushitaDepartment of Gastroenterology, Kumamoto Chuo Hospital, 1-5-1, Tainoshima, Minami-Ku, Kumamoto, 862-0965, Japan.
Tatsuyuki KakumaDepartment of Biostatics Center, Medical School, Kurume University, 67, Asahimachi, Fukuoka, Kurume, 830-0011, Japan.
Shuji TadaDepartment of Gastroenterology, Kumamoto City Hospital, 4-1-60, Higashimachi, Higashi-Ku, Kumamoto, 862-8505, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUnnecessary endoscopic retrograde cholangiopancreatography (ERCP) after spontaneous passage of common bile duct stones (CBDSs) should be avoided. This study aimed to examine the cumulative diagnosis rate and the predictive factors of spontaneous CBDS passage during the interval between the imaging diagnosis and ERCP.

methodsThis multicenter retrospective study included 1260 consecutive patients with native papilla diagnosed with CBDSs using imaging modalities. Predictive factors and cumulative diagnosis rate of spontaneously passed CBDSs during the interval between imaging diagnosis and ERCP were analyzed.

resultsThe overall cumulative diagnosis rate of spontaneous CBDS passage was 6.2% (78/1260) during a mean interval of 5.0 days. In the multivariate analysis, CBDS sized < 6 mm on diagnostic imaging, solitary CBDS on diagnostic imaging, intervals between the imaging diagnosis and ERCP, and nondilated common bile duct (< 10 mm) were the significant factors associated with spontaneous CBDS passage. Specifically, the cumulative diagnosis rate of spontaneous passage was significantly higher in patients with solitary and CBDSs sized < 6 mm than in those with other CBDSs (14.4% [54/376] vs. 2.7% [24/884], P < 0.001). In both the asymptomatic and symptomatic groups, the cumulative diagnosis rate of the spontaneous passage of CBDSs was significantly higher in patients with solitary and CBDSs sized < 6 mm on diagnostic imaging than in those with multiple and/or CBDSs sized ≥ 6 mm on diagnostic imaging during a mean interval of 20.5 and 2.4 days, respectively (asymptomatic group: 22.4% [15/67] vs. 3.5% [4/113], P < 0.001, symptomatic group: 12.6% [39/309] vs. 2.6% [20/771], P < 0.001).

conclusionsSolitary and CBDSs sized < 6 mm on diagnostic imaging can often lead unnecessary ERCP due to spontaneous passage. Preliminary endoscopic ultrasonography immediately before ERCP is recommended, especially in patients with solitary and small CBDSs on diagnostic imaging.

Indexed as

Cholangiopancreatography, Endoscopic RetrogradeGallstonesCommon Bile DuctDuodenumHumansRetrospective StudiesBile duct stoneEndoscopic retrograde cholangiopancreatographySpontaneous passage

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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.