title: Comparison of Outcomes and Complications of Endoscopic Common Bile Duct Stone Removal Between Asymptomatic and Symptomatic Patients.
abstract: BACKGROUND
  Endoscopic retrograde cholangiopancreatography (ERCP) is generally recommended for removal of CBD stones. There were no studies focusing on the role of symptoms related to CBD stone in performing endoscopic stone removal. The aim of our study was to compare outcomes and complications of ERCP between asymptomatic and symptomatic CBD stones.
  
  
  METHODS
  The medical records of 568 patients with naïve papilla who underwent ERCP for treatment of CBD stone from Jan 2009 to Aug 2014 were reviewed and analyzed retrospectively. Patients were divided as asymptomatic group (n = 32) and symptomatic group (n = 536).
  
  
  RESULTS
  Age and gender were not significantly different between the two groups (p > 0.005). Mean sizes of CBD and CBD stones were not significantly different between asymptomatic and symptomatic group (p > 0.05). No differences in performance of needle knife fistulotomy, endoscopic sphincterotomy, and endoscopic papillary balloon dilatation were observed between the two groups (p > 0.05). Unintentional injection into the pancreatic duct was not significantly different between the two groups (p > 0.05). The overall complete stone removal rate was 96.9 % in the asymptomatic group and 94.4 % in the symptomatic group (p = 0.295). Requirement of mechanical lithotripsy was not significantly different between asymptomatic and symptomatic group (18.8 vs 8.4 %, p = 0.057). Significantly higher incidence of post-ERCP pancreatitis was observed in the asymptomatic group than in the symptomatic group (12.5 vs 3.9 %, p = 0.045).
  
  
  CONCLUSIONS
  The overall success rates of CBD stone removal were comparable between asymptomatic and symptomatic patients. However, risk of post-ERCP pancreatitis appears to be increased in patients with asymptomatic CBD stones.
authors.affiliation: Yeungnam University College of Medicine, Daegu, Republic of Korea.
authors.forename: Sung Bum
authors.initials: SB
authors.lastname: Kim
authors.affiliation: Yeungnam University College of Medicine, Daegu, Republic of Korea.
authors.forename: Kook Hyun
authors.initials: KH
authors.lastname: Kim
authors.affiliation: Yeungnam University College of Medicine, Daegu, Republic of Korea. tnkim@yu.ac.kr.
authors.forename: Tae Nyeun
authors.initials: TN
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D058070:Asymptomatic Diseases / Q000628:therapy*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects* / Q000706:statistics & numerical data; D005260:Female; D042882:Gallstones / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies
keywords: Common bile duct stone; ERCP; Outcomes; Symptom