Original articleClinical endoscopyAccuracy of ASGE high-risk criteria in evaluation of patients with suspected common bile duct stones
Section snippets
Study setting
This study was conducted at Sir Run Run Shaw Hospital, which is an urban tertiary-care medical center in east China, where approximately 1000 ERCPs and 3700 cholecystectomies are performed annually.
Study design
Before initiating this study, permission for research was obtained from the ethics committee at Zhejiang University, Sir Run Run Shaw Hospital. Consecutive patients hospitalized between January 2011 to December 2013 with suspected choledocholithiasis who received biochemical testing, abdominal US,
Patient characteristics
During the study period, 2724 patients with suspected choledocholithiasis met the study criteria. The mean (± standard deviation) age of the patients was 55 ± 15 years, 1179 (43%) were male, and 215 (8%) had prior cholecystectomy (Table 1). On presentation, 1878 (69%) patients had at least 1 abnormal liver test result, 1214 (45%) had abnormal bilirubin levels >1.2 mg/dL, 806 (30%) had levels ≥1.8 mg/dL, and 349 (13%) had levels >4 mg/dL. On abdominal US, 1419 (52%) patients had dilated
Discussion
Suspected choledocholithiasis is the most common indication for ERCP.10 Although highly effective for removal of choledocholithiasis, ERCP is a complex endoscopic procedure that often is associated with procedure-related adverse events and even death.10, 11 With the advent of other highly accurate diagnostic modalities to evaluate for choledocholithiasis such as MRCP and EUS, patient selection to minimize ERCP-associated adverse events has evolved to improve patient safety. Furthermore, adverse
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2024, Diagnostic and Interventional ImagingPredictive models in EUS/ERCP
2023, Best Practice and Research: Clinical GastroenterologyClinical Utility of Definitive Diagnostic Tests for Choledocholithiasis in Pediatric Patients with Mild Gallstone Pancreatitis
2023, Journal of Pediatric Surgery
DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.
See CME section; p. 559.
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