Endoscopy 2025; 57(S 02): S542
DOI: 10.1055/s-0045-1806407
Abstracts | ESGE Days 2025
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Predictive Parameters for Unnecessary ERCP: Insights from a Single-Center Study

Authors

  • O Nacir

    1   MOHAMMED VI UNIVERISTY HOSPITAL, Marrakech, Morocco
    2   Faculty of Medicine and Pharmacy, Marrakesh, Morocco

  • F E Lairani

    1   MOHAMMED VI UNIVERISTY HOSPITAL, Marrakech, Morocco

  • A E adil

    1   MOHAMMED VI UNIVERISTY HOSPITAL, Marrakech, Morocco

  • S Oubaha

    1   MOHAMMED VI UNIVERISTY HOSPITAL, Marrakech, Morocco

  • Z Samlani

    1   MOHAMMED VI UNIVERISTY HOSPITAL, Marrakech, Morocco

  • K Krati

    1   MOHAMMED VI UNIVERISTY HOSPITAL, Marrakech, Morocco
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Aims This study aimed to evaluate the risk factors associated with unnecessary endoscopic retrograde cholangiopancreatography (ERCP) in patients with suspected common bile duct (CBD) stones prior to the procedure.

Methods In this retrospective single-center study, we analyzed ERCP records from December 2018 to April 2023. Patients with malignancy (n=30) were excluded. All included patients underwent abdominal imaging prior to ERCP, and laboratory parameters were collected at admission. The statistical analysis was performed using SPSS, and receiver operating characteristic (ROC) curve analysis was employed to identify optimal cut-off values for significant predictors.

Results Among 237 patients, CBD stones were removed in 128 cases (54%). At the time of admission, 131 patients (55.3%) were diagnosed with choledocholithiasis, 31 patients (13.1%) had pancreatitis, 32 patients (13.5%) had cholangitis, and 43 patients (18.1%) presented with cholestasis.

Significant differences were observed between these groups in terms of alkaline phosphatase (ALP), total bilirubin, direct bilirubin, CBD diameter, and CBD stone diameter (p<0.001). Based on ROC curve analysis, the optimal cut-off values for differentiating these groups were:

  • ALP: 223 IU/L (Sensitivity: 67%, Specificity: 67%)

  • Total bilirubin: 3.45 mg/dL (Sensitivity: 76%, Specificity: 76%)

  • Direct bilirubin: 1.75 mg/dL (Sensitivity: 81%, Specificity: 71%)

  • CBD diameter: 9.75 mm (Sensitivity: 52%, Specificity: 60%)

  • CBD stone diameter: 3.2 mm (Sensitivity: 62%, Specificity: 87%)

These findings suggest that patients with values below these thresholds are less likely to benefit from ERCP.

Conclusions This study highlights ALP, total bilirubin, direct bilirubin, CBD diameter, and CBD stone diameter as significant predictors of unnecessary ERCP. The identified cut-off values—223 IU/L, 3.45 mg/dL, 1.75 mg/dL, 9.75 mm, and 3.2 mm, respectively—may help in the pre-procedural selection of patients, potentially reducing the rate of unnecessary ERCP procedures. Further large-scale, prospective studies are required to validate these findings and establish robust clinical guidelines.



Publication History

Article published online:
27 March 2025

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