title: Is endoscopic treatment beneficial in patients with clinically suspicious of common bile duct stones but no obvious filling defects during the ERCP examination?
abstract: BACKGROUND
  Sometimes, no definite filling defect could be found by cholangiogram (ERC) during the endoscopic retrograde cholangio-pancreatiographic (ERCP) exam; even prior images had evidence of common bile duct stones (CBDS). We aimed in estimating the positive rate of extraction of CBDS who had treated by endoscopic sphincterotomy/endoscopic papillary balloon dilation (EST/EPBD) with negative ERC finding.
  
  
  METHODS
  One hundred forty-one patients with clinically suspicious of CBDS but negative ERC, who had received EST/EPBD treatments was enrolled. Potential factors for predicting CBDS, as well as the treatment-related complications were analyzed.
  
  
  RESULTS
  Nearly half of the patients with negative ERC, had a positive stone extraction. Only patients with high probability of CBDS were significantly associated with positive stone extraction. Moreover, patients with intermediate probability of CBDS had higher rates of overall complications, including post-ERCP pancreatitis. In addition, no significant difference of post-ERCP pancreatitis was found between EST and EPBD groups in any one group of patients with the same probability of CBDS.
  
  
  CONCLUSIONS
  Regarding patients with negative ERC, therapeutic ERCP is beneficial and safe for patients present with high probability of CBDS. Moreover, under the same probability of CBDS, there was no significance difference in post-ERCP pancreatitis between EST and EPBD.
authors: Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Road, Kaohsiung, 81362, Taiwan.
authors: Po-Hung
authors: PH
authors: Chiang
authors: Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Road, Kaohsiung, 81362, Taiwan.|School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Li-Nong Street, Pei-Tou, Taipei, 112, Taiwan.
authors: Kwok-Hung
authors: KH
authors: Lai
authors: Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Road, Kaohsiung, 81362, Taiwan.
authors: Tzung-Jiun
authors: TJ
authors: Tsai
authors: Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Road, Kaohsiung, 81362, Taiwan.
authors: Kung-Hung
authors: KH
authors: Lin
authors: Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Road, Kaohsiung, 81362, Taiwan.
authors: Kai-Ming
authors: KM
authors: Wang
authors: Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Road, Kaohsiung, 81362, Taiwan.|School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Li-Nong Street, Pei-Tou, Taipei, 112, Taiwan.
authors: Sung-Shuo
authors: SS
authors: Kao
authors: Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Road, Kaohsiung, 81362, Taiwan.
authors: Wei-Chih
authors: WC
authors: Sun
authors: Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Road, Kaohsiung, 81362, Taiwan.|School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Li-Nong Street, Pei-Tou, Taipei, 112, Taiwan.
authors: Jin-Shiung
authors: JS
authors: Cheng
authors: Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Road, Kaohsiung, 81362, Taiwan.|School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Li-Nong Street, Pei-Tou, Taipei, 112, Taiwan.
authors: Ping-I
authors: PI
authors: Hsu
authors: Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Road, Kaohsiung, 81362, Taiwan.|School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Li-Nong Street, Pei-Tou, Taipei, 112, Taiwan.
authors: Wei-Lun
authors: WL
authors: Tsai
authors: Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Road, Kaohsiung, 81362, Taiwan.|School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Li-Nong Street, Pei-Tou, Taipei, 112, Taiwan.
authors: Wen-Chi
authors: WC
authors: Chen
authors: Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Road, Kaohsiung, 81362, Taiwan.
authors: Yun-Da
authors: YD
authors: Li
authors: Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Road, Kaohsiung, 81362, Taiwan.
authors: E-Ming
authors: EM
authors: Wang
authors: Department of Health-Business Administration, Fooyin University, 151 Jinxue Rd, Daliao Dist, Kaohsiung City, 83102, Taiwan. sc035@fy.edu.tw.
authors: Huey-Shyan
authors: HS
authors: Lin
authors: Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Road, Kaohsiung, 81362, Taiwan. hoihungchan@gmail.com.|School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Li-Nong Street, Pei-Tou, Taipei, 112, Taiwan. hoihungchan@gmail.com.|Department of Biological Sciences, National Sun Yat-sen University, 70 Lien-Hai Road, Kaohsiung, 80424, Taiwan. hoihungchan@gmail.com.|Department of Business Management, National Sun Yat-sen University, 70 Lien-Hai Road, Kaohsiung, 80424, Taiwan. hoihungchan@gmail.com.|College of Pharmacy and Health Care, Tajen University, 20 Weisin Road, Sin-er Village, Yanpu Township, Pingtung County, 907, Taiwan. hoihungchan@gmail.com.
authors: Hoi-Hung
authors: HH
authors: Chan
mesh_terms: D000368:Aged; D002404:Catheterization / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D002758:Cholangiography / Q000379:methods / Q000706:statistics & numerical data; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods / Q000706:statistics & numerical data*; D042883:Choledocholithiasis / Q000000981:diagnostic imaging / Q000601:surgery*; D004106:Dilatation / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000453:epidemiology / Q000209:etiology; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D016717:Sphincterotomy, Endoscopic / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D016896:Treatment Outcome
keywords: CBDS; ERC; ERCP