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©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Jul 14, 2009; 15(26): 3283-3287
Published online Jul 14, 2009. doi: 10.3748/wjg.15.3283
Is ERCP really necessary in case of suspected spontaneous passage of bile duct stones?
Yuji Sakai, Toshio Tsuyuguchi, Takeshi Ishihara, Seigo Yukisawa, Tadashi Ohara, Masaru Tsuboi, Yoshihiko Ooka, Kazuki Kato, Kiyotake Katsuura, Michio Kimura, Makoto Takahashi, Kazuhisa Nemoto, Masaru Miyazaki, Osamu Yokosuka
Yuji Sakai, Toshio Tsuyuguchi, Takeshi Ishihara, Seigo Yukisawa, Osamu Yokosuka, Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan
Yuji Sakai, Tadashi Ohara, Masaru Tsuboi, Yoshihiko Ooka, Kazuki Kato, Kiyotake Katsuura, Michio Kimura, Department of Internal Medicine, Funabashi Central Hospital, Funabashi City, Chiba 273-8556, Japan
Makoto Takahashi, Department of Surgery, Funabashi Central Hospital, Funabashi City, Chiba 273-8556, Japan
Kazuhisa Nemoto, Department of Radiology, Funabashi Central Hospital, Funabashi City, Chiba 273-8556, Japan
Masaru Miyazaki, Department of General Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan
Author contributions: Sakai Y, Tsuyuguchi T, Ishihara T, and Yukisawa S were responsible for study design, data analysis, and manuscript preparation; Sakai Y wrote the paper, performed endoscopic treatment; Ohara T, Tsuboi M, Ooka Y, Kato K, Katsuura K, Kimura M and Nemoto K were responsible for data collection; Takahashi M performed the surgical procedure; Miyazaki M and Yokosuka O reviewed this manuscript.
Correspondence to: Yuji Sakai, MD, Department of Medicine and Clinical Oncology (K1), Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chuou-ku, Chiba 260-8670, Japan.
sakai4754@yahoo.co.jp
Telephone: +81-43-2262083
Fax: +81-43-2262088
Received: March 29, 2009
Revised: June 3, 2009
Accepted: June 10, 2009
Published online: July 14, 2009
AIM: To investigate the usefulness of magnetic resonance cholangiopancreatography (MRCP) and the need for endoscopic retrograde cholangiopancreatography (ERCP) in cases of suspected spontaneous passage of stones into the common bile duct.
METHODS: Thirty-six patients with gallbladder stones were clinically suspected of spontaneous passage of stones into the common bile duct because they presented with clinical symptoms such as abdominal pain and fever, and showed signs of inflammatory reaction and marked rise of hepatobiliary enzymes. These symptoms resolved and they showed normalized values of blood biochemical parameters after conservative treatment without evidence of stones in the common bile duct on MRCP. All these patients were subjected to ERCP within 3 d of MRCP to check for the presence of stones.
RESULTS: No stones were detected by ERCP in any patient, confirming the results of MRCP.
CONCLUSION: When clinical symptoms improve, blood biochemical parameters have normalized, and MRCP shows there are no stones in the common bile duct, it can be considered the stone has spontaneously passed and thus ERCP is not necessary.
