Year 2017 / Volume 109 / Number 4
Letter to the Editor
Diagnosis and management of patients with an intermediate probability of choledocholithiasis

313

DOI: 10.17235/reed.2017.4549/2016

José Alberto González González, Roberto Monreal Robles,

Abstract
We thank Dr. Dib for his interest in our prospective study, in which we assessed the accuracy of the American Society for Gastrointestinal Endoscopy guidelines for the prediction of choledocholithiasis (CL). The guidelines suggest the option of using a less-invasive initial test including endoscopic ultrasonography (EUS) or magnetic resonance cholangiopancreatography (MRCP) in patients with intermediate probability of CL. However, there is a paucity of published literature supporting this recommendation. Furthermore, in the study by Adams et al. (3) such a recommendation is not supported by their data. Additionally, because the prevalence of CL varies among ethnic groups, we did not consider performing pre-ERCP (endoscopic retrograde cholangiopancreatography) imaging studies in our study.
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References
1. Narvaez Rivera RM, Gonzalez Gonzalez JA, Monreal Robles R, et al. Accuracy of ASGE criteria for the prediction of choledocholithiasis. Rev Esp Enferm Dig 2016; 108: 309-314
2. Committee ASoP, Maple JT, Ben-Menachem T, et al. The role of endoscopy in the evaluation of suspected choledocholithiasis. Gastrointest Endosc 2010; 71: 1-9
3. Adams MA, Hosmer AE, Wamsteker EJ, et al. Predicting the likelihood of a persistent bile duct stone in patients with suspected choledocholithiasis: accuracy of existing guidelines and the impact of laboratory trends. Gastrointest Endosc 2015; 82: 88-93
4. Iranmanesh P, Frossard JL, Mugnier-Konrad B, et al. Initial cholecystectomy vs sequential common duct endoscopic assessment and subsequent cholecystectomy for suspected gallstone migration: a randomized clinical trial. JAMA 2014; 312: 137-144
5. Tarnasky P, Kedia P. Regarding: Validation and improvement of a proposed scoring system to detect retained common bile duct stones in gallstone pancreatitis. Surgery 2016; 159: 985-986
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González González J, Monreal Robles R. Diagnosis and management of patients with an intermediate probability of choledocholithiasis. 4549/2016


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Publication history

Received: 18/07/2016

Accepted: 20/07/2016

Online First: 27/02/2017

Published: 31/03/2017

Article Online First time: 224 days

Article editing time: 256 days


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