Predictive model of persistent choledocholithiasis in patients with acute biliary pancreatitis

• Published in: Gastroenterología y Hepatología (English Edition) 2023-04, Vol.46 (4), p.297-304
• Main Authors: Mínguez, Alejandro, Ladrón, Pablo, Martínez, Sara, Del Val, Adolfo, Nos, Pilar, de-Madaria, Enrique
• Format: Article
• Language: English
• Subjects: Acute biliary pancreatitis; Choledocolitiasis; Colangiografía por resonancia magnética; Colangiopancreatografía retrógrada endoscópica; Coledocolitiasis; Endoscopic retrograde cholangiopancreatography; Magnetic resonance imaging cholangiography; Modelo predictivo; Pancreatitis aguda biliar; Predictive model
• ISSN: 2444-3824; 2444-3824
• DOI: 10.1016/j.gastre.2022.10.003

Choledocholithiasis causing acute biliary pancreatitis (ABP) may migrate to the duodenum or persist in the common bile duct (CBD). We developed a model for predicting persistent choledocholithiasis (PC) in patients with ABP. This retrospective cohort study included 204 patients, age ≥18 years (mean age: 73 years, 65.7% women), admitted for ABP in 2013–2018, with at least a magnetic resonance cholangiopancreatography (MRCP), endoscopic ultrasonography (EUS), and/or endoscopic retrograde cholangiopancreatography (ERCP). Epidemiological, analytical, imaging, and endoscopic variables were compared between patients with and without PC. Multivariate logistic regression analyses were performed to develop a predictive model of PC. Patients underwent MRCP (n=145, 71.1), MRCP and ERCP (n=44, 21.56%), EUS and ERCP (n=1, 0.49%), or ERCP (n=14, 6.86%). PC was detected in 49 patients (24%). PC was strongly associated with CBD dilation, detected in the emergency ultrasound (p