Endoscopy 2019; 51(04): S232
DOI: 10.1055/s-0039-1681864
ESGE Days 2019 ePosters
Friday, April 5, 2019 09:00 – 17:00: ERCP ePosters
Georg Thieme Verlag KG Stuttgart · New York

ASSOCIATED FACTORS WITH ABSCENSE OF BILE DUCT STONE AT ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP) IN PATIENTS WITH CHOLEDOCHOLITHIASIS DOCUMENTED ON MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY (MRCP)

R Palos-Cuellar
1   Endoscopy Unit, Instituto Mexicano del Seguro Social, Mexico City, Mexico
,
E Murcio-Pérez
1   Endoscopy Unit, Instituto Mexicano del Seguro Social, Mexico City, Mexico
,
A Ferreira-Hermosillo
2   Research Unit, Instituto Mexicano del Seguro Social, Mexico City, Mexico
,
OM Solórzano-Pineda
1   Endoscopy Unit, Instituto Mexicano del Seguro Social, Mexico City, Mexico
,
G Blanco-Velasco
1   Endoscopy Unit, Instituto Mexicano del Seguro Social, Mexico City, Mexico
,
OV Hernández-Mondragón
1   Endoscopy Unit, Instituto Mexicano del Seguro Social, Mexico City, Mexico
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

 

Aims:

Determine factors associated with abscense of bile duct stone at ERCP in patients with choledocholithiasis documented on MRCP.

Methods:

A retrospective, cross-sectional, analytical study of patients with choledocholithiasis on MRCP undergoing ERCP from January 2016 to January 2018 at a referal endoscopy center. The clinical, biochemical, radiological and ERCP findings were analized.

Results:

Two hundred eigtheen patients with choledocholithiasis documented on magnetic resonance MRCP undergoing ERCP were included. Most patients were female (66.5%) with a median age of 66.5 years (range 18 – 96). MRCP findings were as follows: mean bile stone size 7 mm. (range 2 – 20), mean bile duct diameter 11 mm (range 6 – 27), median number of stones at bile duct 1 (range 1 – 15). Median days between MRPC and ERCP was 19 (range 1 – 173). Laboratory values before ERCP were: white blood cells 7.05 × 103/mm3, total bilirubin 3.18 mg/dL (range 0.15 – 18.4), direct bilirubin 2.7 mg/dL (range 0.1 – 18), alkaline phosphatase 230 UI/L (range 34 – 923), GGT 405 UI/L (10 – 3020), AST 45 UI/L (range 10 – 827), ALT 45 (range 3 – 970).

At ERCP stone was found on 173 patients (79.4%). Patients without bile duct stone on ERCP had lower alkaline phosphatase levels (139 vs. 220 UI/L p = 0.017), lower mean bile duct diameter on MRCP (11 vs. 12 mm. p = 0.009) and lower bile duct stone size on MRCP (6 vs. 9 mm. p = 0.002) than patients with bile duct stone at ERCP.

Predictors of bile duct absence at ERCP: bile duct diameter < 10 mm on MRCP (OR 0.31 CI95% 0.14 – 0.67), bile duct stone size < 6 mm on MRCP (OR 0.32 CI 95% 0.13 – 0.78) and a cut-off value of 129 UI/L alkaline phosphatase before ERCP (OR 0.40 CI95% 0.19 – 0.83).

Conclusions:

Normal phosphatase, common bile duct diameter < 10 mm and bile duct stone size < 6 mm on MRCP were predictive factors of stone abscense at ERCP on patients with choledocholithiasis on MRCP.