Parameters Suggesting Spontaneous Passage of Stones from Common Bile Duct: A Retrospective Study

Autor: 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
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: Canadian Journal of Gastroenterology and Hepatology, Vol 2019 (2019)
Druh dokumentu: article
ISSN: 2291-2789
2291-2797
DOI: 10.1155/2019/5382708
Popis: 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
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