ArticleSurgical endoscopy2025
Suspected common bile duct stones: Which test is best?
Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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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.
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.
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Who cites it
4 citing papers in PubMed.
- Mid-to-long-term follow-up study on the application of cystic duct patency test and cystic duct exploration in laparoscopic cholecystectomy for calculous cholecystitis: Xinjiang-Gu laparoscopic cystic duct exploration.Surgical endoscopy · 2026Article
- Article
- Cross-Modal Assessment of Post-Cholecystectomy Symptoms: Integrating MRCP Metrics with Upper Endoscopy.Tomography (Ann Arbor, Mich.) · 2026Article
- Endoscopic Ultrasound and Endoscopic Retrograde Cholangiopancreatography for Bile Duct Stones-Avoiding the Avoidable.Biomedicines · 2026Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe American Society for Gastrointestinal Endoscopy (ASGE) guidelines for common bile duct (CBD) stone management were created to risk stratify patients into low, intermediate, and high-risk groups to optimize interventions. Low-risk patients typically proceed to cholecystectomy with or without Intra-operative cholangiogram (IOC) whereas high-risk patients typically proceed to common duct clearance. The optimum management of intermediate-risk patients still widely varies. This study aims to characterize the use of MRCP, IOC, and endoscopic ultrasound (EUS) in patients with intermediate risk of CBD stones. METHODS AND PROCEDURES: This is a retrospective analysis of data from the Eastern Association for the Surgery of Trauma (EAST) Retained Common Bile Duct stone database comprised of deidentified data and outcomes of patients prospectively admitted with suspected CBD stones and/or acute biliary pancreatitis from 12 US medical centers between 2016 and 2019. Analysis of the testing characteristics sensitivity (SN), specificity (SP), and predictive values (positive (PPV) and negative (NPV)) were calculated for MRCP, EUS, and IOC based on definitive identification of CBD stones.
results736 patients met inclusion criteria. 521 met the ASGE intermediate risk of choledocholithiasis criteria. 208/521 (39.9%) underwent pre-op MRCP, 44/521 (8.4%) underwent pre-op EUS, and 238/521 (45.7%) underwent IOC.
conclusionsThere is little role for MRCP for ASGE intermediate-risk patients as this modality has both lower sensitivity and specificity than EUS and IOC. When available, either EUS or IOC is the preferred option for diagnostic clarification to identify the choledocholithiasis in this group.
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