Predictors of incomplete common bile duct stone clearance at index endoscopic retrograde cholangiopancreatography

Table 1 Univariate analysis on predictors of common bile duct stone clearance, n (%)

Parameters	Not cleared (n = 66)	Cleared (n = 179)	P value
Demographic and clinical parameters
Age (years)	49.5 (40-58)	45 (33-58)	0.1307
Gender (male:female)	17:49	43:136	0.908
Pain abdomen	58 (87.8)	133 (74.3)	0.0264
Jaundice	21 (31.8)	40 (22.3)	0.1302
Baseline lab parameters
Hb (g/dL)	11.9 (10.5-12.97)	11.9 (10.9-12.7)	0.83
TLC (cells/mm3)	7600 (6550-8790)	7600 (6450-9100)	0.85
Platelets (cells × 105/mm3)	2.3 (1.63-2.87)	2.3 (1.7-3.0)	0.59
Total bilirubin (mg/dL)	0.9 (0.5-2.05)	0.7 (0.5-1.3)	0.076
ALT (IU/L)	34 (20-94)	42 (23-83)	0.28
AST (IU/L)	38.5 (27-75.5)	41 (26-78)	0.97
ALP (IU/L)	188 (129-346)	180 (127-312)	0.86
MRCP variables
CBD diameter > 15 mm	13 (19.7)	19 (10.6)	0.06
CBD diameter in mm	11.93 ± 4.57	10.68 ± 3.41	0.02
Stone number (> 3)	3 (4.5)	12 (6.7)	0.52
Stone size > 12 mm	16 (24.2)	16 (8.9)	0.001
Stone size (mm)	9.97 ± 4.90	7.73 ± 3.36	0.0001
Location of stone (proximal)	12 (18.2)	18 (10.1)	0.57
Stone to CBD diameter > 1	26 (39.3)	28 (15.6)	0.0014
ERCP variables
PAD	6 (9.1)	17 (9.5)	0.94
Bulky papilla	6 (9.1)	5 (2.8)	0.03
Difficult cannulation	16 (24.2)	14 (7.8)	0.001
CBD diameter > 15 mm	9 (13.6)	20 (11.2)	0.10
CBD Diameter (mm)	13.11 ± 5.10	11.72 ± 3.34	0.02
Stone number (> 3)	3 (4.5)	19 (10.6)	0.51
Stone size (mm)	13.77 ± 6.03	8.93 ± 3.89	0.0001
Location of stone (proximal)	8 (12.1)	18 (10.05)	0.02
CBD stricture	4 (6.1)	3 (1.6)	0.05
Hepatolithiasis	8 (12.1)	10 (5.6)	0.08
Impacted stone	16 (24.2)	5 (2.8)	0.0001
Use of a basket for extraction	1 (1.5)	3 (1.7)	0.94
Balloon sphincteroplasty	15 (19.7)	61 (80.2)	0.067

ALP: Alkaline phosphatase; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; CBD: Common bile duct; ERCP: Endoscopic retrograde cholangiopancreatography; Hb: Hemoglobin; MRCP: Magnetic resonance cholangiopancreatography; PAD: Periampullary diverticulum; TLC: Total leukocyte count.

Table 2 Multivariate logistic regression for predictors of Incomplete common bile stones clearance

Variable	OR	95%CI	P value
Pain abdomen	2.35	0.71-7.76	0.159
CBD diameter on MRCP	1.14	0.92-1.42	0.219
Stone size on MRCP	1.32	0.98-1.77	0.066
Stone size > 12 on MRCP	0.53	0.10-2.79	0.454
Stone-to-CBD diameter ratio > 1 on MRCP	3.14	0.88-11.20	0.077
Bulky papilla	2.25	0.26-18.90	0.453
Difficult cannulation	3.07	0.64-14.60	0.158
CBD diameter on ERCP	1.03	0.82-1.30	0.759
Proximal location of the stone on ERCP	4.44	1.67-11.75	0.003
Stone size on ERCP	1.02	0.85-1.19	0.909
Stone size > 12 on ERCP	2.40	0.44-12.90	0.305
Stone size/CBD diameter > 1 on ERCP	5.22	1.14-23.78	0.033
Stricture on ERCP	5.06	1.006-25.52	0.049
Impacted stone on ERCP	9.33	2.17-39.99	0.003

CI: Confidence interval; OR: Odds ratio; MRCP: Magnetic resonance cholangiopancreatography; CBD: Common bile duct; ERCP: Endoscopic retrograde cholangiopancreatography.