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| 1 | Predictors of recurrent bile duct stone after clearance by endoscopic retrograde cholangiopancreatography:A case-control study显示文摘Background:Recurrent common bile duct(CBD)stone is a long-term sequalae among patients who un-derwent endoscopic retrograde cholangiopancreatography(ERCP)with CBD stone extraction.Data regard-ing risk factors for recurrent CBD stone are scarce.We aimed to identify predictors of recurrent CBD stone.Methods:We performed a retrospective case-controlled study from January 2010 to December 2019.In-clusion criteria included patients who had recurrent CBD stone at least 6 months after the index ERCP,in which complete stone extraction was performed and normal cholangiogram was obtained.Overall,457 patients were included.Forty-two patients(9.2%)had recurrent CBD stone,and 415 patients(90.8%)did not have recurrent CBD stone.Results:In univariate analysis,male sex[odds ratio(OR)=0.49,P=0.033]was a protective factor,while endoscopic stone extraction by basket vs.balloon(OR=2.55,P=0.005),older age(OR=1.03,P=0.003),number of CBD stones(OR=1.99,P=0.037),size of CBD stone(OR=4.06,P=0.003)and mechanical lithotripsy(OR=9.22,P=0.004)were risk factors for recurrent CBD stone.In multivariate logistic regression analysis,mechanical lithotripsy[OR=9.73,95%confidence interval(CI):1.69-55.89,P=0.010],basket clearance vs.combined basket and balloon(OR=18.25,95%CI:1.05-318.35,P=0.046)and older age(OR=1.02,95%CI:1.00-1.05,P=0.023)were risk factors,and male sex(OR=0.39,95%CI:0.19-0.81,P=0.012)was a protective factor. | Wisam Sbeit Anas Kadah Matta Simaan Amir Shahin Tawfik Khoury | 2022 | Hepatobiliary & Pancreatic Diseases International2022，21，1： | 5 |
| 2 | Predicting common bile duct stones by non-invasive parameters显示文摘Background:Common bile duct(CBD)stone affect about 10%of patients with symptomatic cholelithiasis.The American Society for Gastrointestinal Endoscopy(ASGE)published a strategy in 2010 for managing patients with suspected choledocholithiasis.This study aimed to assess the performance of different clinical parameters in predicting CBD stones.Methods:A total of 344 patients suspected to suffer from CBD stone and referred to endoscopic ultrasound(EUS)were included.Parameters were collected and their prediction power for CBD stones was assessed.Results:One hundred and sixty-seven patients without CBD stone according to EUS(group A)were compared to 177 patients with CBD stones(group B).Several predictive factors for CBD stone were identified on univariate analysis.In multivariate regression analysis,CBD width by US(OR=1.224,95%CI:1.073–1.359;P=0.0026),age(OR=1.023,95%CI:1.011–1.035;P=0.0002)and gamma glutamyl transferase(GGT)level(OR=1.001,95%CI:1.000–1.002;P=0.0018)were significantly correlated with CBD stone,with receiver operator characteristics(ROC)of 0.7259.We generated a diagnostic equation[age(yr)×0.1+CBD width(mm)by US×1+GGT(U/L)×0.005]to predict CBD stone with ROC of 0.7287.Conclusions:We suggest this score as a very strong predictor for CBD stones,and to reduce the strength of total bilirubin and transaminases as predictors. | Anas Kadah Tawfik Khoury Mahmud Mahamid Nimer Assy Wisam Sbeit | 2020 | Hepatobiliary & Pancreatic Diseases International2020，19，3： | 4 |
| 3 | Bedside score predicting retained common bile duct stone in acute biliary pancreatitis显示文摘BACKGROUND Retained common bile duct(CBD) stone after an acute episode of biliary pancreatitis is of paramount importance since stone extraction is mandatory.AIM To generate a simple non-invasive score to predict the presence of CBD stone in patients with biliary pancreatitis.METHODS We performed a retrospective study including patients with a diagnosis of biliary pancreatitis. One hundred and fifty-four patients were included. Thirty-three patients(21.5%) were diagnosed with CBD stone by endoscopic ultrasound(US).RESULTS In univariate analysis, age(OR: 1.048, P = 0.0004), aspartate transaminase(OR:1.002, P = 0.0015), alkaline phosphatase(OR: 1.005, P = 0.0005), gamma-glutamyl transferase(OR: 1.003, P = 0.0002) and CBD width by US(OR: 1.187, P = 0.0445)were associated with CBD stone. In multivariate analysis, three parameters were identified to predict CBD stone;age(OR: 1.062, P = 0.0005), gamma-glutamyl transferase level(OR: 1.003, P = 0.0003) and dilated CBD(OR: 3.685, P = 0.027),with area under the curve of 0.8433. We developed a diagnostic score that included the three significant parameters on multivariate analysis, with assignment of weights for each variable according to the co-efficient estimate. A score that ranges from 51.28 to 73.7 has a very high specificity(90%-100%) for CBD stones, while a low score that ranges from 9.16 to 41.04 has a high sensitivity(82%-100%). By performing internal validation, the negative predictive value of the low score group was 93%.CONCLUSION We recommend incorporating this score as an aid for stratifying patients with acute biliary pancreatitis into low or high probability for the presence of CBD stone. | Tawfik Khoury Anas Kadah Mahmud Mahamid Amir Mari Wisam Sbeit | 2020 | World Journal of Clinical Cases2020，8，8： | 0 |
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