The high rate of spontaneous migration of small size common bile duct stones may allow a significant reduction in unnecessary ERCP and related complications: results of a retrospective, multicenter study

Can inflammatory indexes predict the spontaneous passage of common bile duct stones?

“…It is clear that there is a possibility of spontaneous migration in at least 20% of the stones, but different spontaneous migration rates may have been reported depending on the retrospective nature of the studies and likely due to the differences in the study designs. 2,3,[7][8][9] As predicted, small stones, especially those <5 mm in size, have a higher likelihood of spontaneous passage. 2,3,[7][8][9] While the average stone size was 6 mm in the group that stones were detected in the ERCPs, the average stone size was 3 mm in the group without stones, and our findings support the claim that the smaller the stone size, the greater the likelihood of spontaneous migration.…”

“…1 Before ERCP, there is a need for additional methods to be applied per patient where clinical and laboratory data are analyzed. 2,3,[7][8][9] A spontaneous stone passage was detected in 27.2% of the study's cases. In the study by Reid et al, 10 the rate of cases in which stones were detected on MRCP but undetected on ERCP was 24.57%.…”

“…Khoury et al 2 reported that advanced age increased the probability of stone detection in ERCPs, but it was stated that age was not a factor associated with spontaneous passage. 3 Small and single stones were reported to be independent predictors of spontaneous passage. 3 According to the present study's results, it can be considered that the probability of spontaneous passage is higher in single stones accompanying small-size stones.…”

“…3 Small and single stones were reported to be independent predictors of spontaneous passage. 3 According to the present study's results, it can be considered that the probability of spontaneous passage is higher in single stones accompanying small-size stones. However, some publications also report that the number of stones is not decisive for spontaneous passage.…”

“…6 Despite the high diagnostic efficacy of both EUS and MRCP, there is always the possibility of unnecessary therapeutic ERCP due to the probability of spontaneous passage. 2,3 One-fifth to one-third of the stones were reported to discharge spontaneously, and smaller stones are more prone to migration. [7][8][9] Since unnecessary ERCP procedures frequently associate with high rates of complications, the exact indications are imperative to avoid post-ERCP complications.…”