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Endoscopic treatment for choledocholithiasis in asymptomatic patients
Author(s) -
Xu XiaoDan,
Qian JianQing,
Dai JianJun,
Sun ZhenXing
Publication year - 2020
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.14790
Subject(s) - medicine , asymptomatic , odds ratio , endoscopic retrograde cholangiopancreatography , gastroenterology , surgery , incidence (geometry) , complication , retrospective cohort study , pancreatitis , confidence interval , physics , optics
Abstract Background and Aim A few small retrospective studies recently found that endoscopic retrograde cholangiopancreatography (ERCP) in asymptomatic compared with symptomatic common bile duct stones (CBDSs) patients appeared to increase the risk of post‐ERCP pancreatitis (PEP). This study aimed to determine the risk of ERCP in asymptomatic CBDS patients. Methods A total of 327 consecutive patients with native papilla were invited to participate into the study and divided into two groups: 53 in the asymptomatic group and 274 in the symptomatic group, who underwent CBDS removal by ERCP. Patient's characteristics and outcomes were analyzed. Results A total of 46 (14.1%) patients had ERCP‐related complications, including PEP, cholangitis, perforation, and bleeding. The overall complication rate in the asymptomatic group was higher than in the control group (26.4% vs 11.7%, P < 0.01). PEP was the most common complication (30/327, 9.2%). Of the 30 cases of PEP, 25 (83.3%) were mild, and the severity in both groups was similar (9/1/1 vs 16/2/1, P > 0.05). The incidence rate of PEP in the asymptomatic group was higher than in the symptomatic group (20.8% vs 6.9%, P < 0.01). Multivariate regression analysis identified asymptomatic CBDSs (odds ratio = 0.241, 95% confidence interval: 0.092–0.628) as being independently associated with PEP occurrence. Conclusion Asymptomatic CBDSs were associated with increased incidence of PEP compared with symptomatic CBDSs.