Evidence map›Paper›PMID 39786463›Full record

ArticleSurgical endoscopy2025

Post-ERCP clearance of bile duct stones: should the gallbladder be left in-situ?

Cindy Siaw Lin Wong, Arya Krishnan, Naren Kumaran, Nicola Tanner

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Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Cindy Siaw Lin WongDepartment of General Surgery, Northampton General Hospital NHS Trust, Cliftonville, Northamptonshire, NN15BD, UK. lin_0702cindy@hotmail.com.ORCID 0009-0007-2942-3807
Arya KrishnanDepartment of General Surgery, Northampton General Hospital NHS Trust, Cliftonville, Northamptonshire, NN15BD, UK.
Naren KumaranDepartment of General Surgery, Northampton General Hospital NHS Trust, Cliftonville, Northamptonshire, NN15BD, UK.
Nicola TannerDepartment of General Surgery, Northampton General Hospital NHS Trust, Cliftonville, Northamptonshire, NN15BD, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEndoscopic retrograde cholangiopancreatography (ERCP) has become the gold standard management for patients who present with common bile duct stone (CBDS). Although laparoscopic cholecystectomy is generally recommended for patients who have CBDS clearance, there is still a significant proportion of patients who are managed expectantly. Our study aimed to evaluate the outcomes of expectant management (EM) versus prophylactic cholecystectomy after initial endoscopic removal of CBDS.

methodWe performed a retrospective review of all patients who underwent ERCP for choledocholithiasis from 1st January 2017 to 31st December 2019. Patients were further classified into young or elderly group using age 60 years as the cut-off. Primary outcomes measured biliary-related complications in each interventional group whereas secondary outcomes measured all-cause mortality.

results136 patients (51.3%) had EM whereas 129 patients (48.7%) were initially planned for LC. There was 20.6% of recurrence of biliary events in EM group as compared to 3.9% in LC group. The median time from first ERCP to recurrence of biliary events in the EM group was 14 months. Overall complications of LC group was low (5.4%) with nil operative-related mortality. However, there was a significant higher proportion of elderly patients in EM group in comparison to LC group (88.2% vs 31%) and 51.4% of EM group died during follow-up period with only one biliary-related death.

conclusionProphylactic cholecystectomy should be recommended for patients who have undergone ERCP clearance of CBDS. A watch-and-wait approach may be justified for elderly populations who are not ideal surgical candidates and a follow-up duration of up to 2 years is recommended.

Indexed as

Cholangiopancreatography, Endoscopic RetrogradeCholecystectomyCholecystectomy, LaparoscopicCholedocholithiasisGallbladderGallstonesWatchful WaitingAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedPostoperative ComplicationsRecurrenceCBD stoneCholecystectomyERCP

Identifiers

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.