title: Is ERCP really necessary in case of suspected spontaneous passage of bile duct stones?
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors: Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan. sakai4754@yahoo.co.jp
authors: Yuji
authors: Y
authors: Sakai
authors: Toshio
authors: T
authors: Tsuyuguchi
authors: Takeshi
authors: T
authors: Ishihara
authors: Seigo
authors: S
authors: Yukisawa
authors: Tadashi
authors: T
authors: Ohara
authors: Masaru
authors: M
authors: Tsuboi
authors: Yoshihiko
authors: Y
authors: Ooka
authors: Kazuki
authors: K
authors: Kato
authors: Kiyotake
authors: K
authors: Katsuura
authors: Michio
authors: M
authors: Kimura
authors: Makoto
authors: M
authors: Takahashi
authors: Kazuhisa
authors: K
authors: Nemoto
authors: Masaru
authors: M
authors: Miyazaki
authors: Osamu
authors: O
authors: Yokosuka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde; D049448:Cholangiopancreatography, Magnetic Resonance; D003135:Common Bile Duct / Q000473:pathology*; D005260:Female; D042882:Gallstones / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies