{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T18:27:18Z","timestamp":1783708038759,"version":"3.55.0"},"reference-count":23,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T00:00:00Z","timestamp":1638403200000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JGH Open"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Current guidelines recommend the removal of common bile duct (CBD) stones by endoscopic retrograde cholangiopancreatography (ERCP) for both asymptomatic and symptomatic patients. We conducted this study because of the limited research comparing the risks of ERCP\u2010related complications between these two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study involved 1491 patients with native major duodenal papilla diagnosed with choledocholithiasis at three institutions in Japan. The rates of ERCP\u2010related complications, including post\u2010ERCP pancreatitis (PEP), cholangitis, bleeding, and perforation, were compared using one\u2010to\u2010one propensity score matching between the asymptomatic and symptomatic patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Complications were observed in 112 (7.5%) of the 1491 patients (asymptomatic group: 31\/172 [18.0%] <jats:italic>vs<\/jats:italic> symptomatic group: 81\/1319 [6.1%], <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). The rate of severe complications was higher in the asymptomatic group than that in the symptomatic group (asymptomatic group: 5\/31 [16.1%] <jats:italic>vs<\/jats:italic> symptomatic group:  3\/81 [3.7%], <jats:italic>P<\/jats:italic>\u00a0=\u00a00.036). In the propensity\u2010matched asymptomatic and symptomatic patients, the incidences of PEP, cholangitis, bleeding, and perforation were 18\/143 (12.6%) <jats:italic>vs<\/jats:italic> 4\/143 (2.8%) (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.003); 4\/107 (3.7%) <jats:italic>vs<\/jats:italic> 6\/107 (5.6%) (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.75); 1\/140 (0.7%) <jats:italic>vs<\/jats:italic> 3\/140 (2.1%) (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.62); and 2\/140 (1.4%) <jats:italic>vs<\/jats:italic> 2\/140 (1.4%) (<jats:italic>P<\/jats:italic>\u00a0=\u00a01.0).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>ERCP for asymptomatic patients with CBD stones is associated with a higher risk of overall and severe complications than that for symptomatic patients with CBD stones; the overall rate is influenced by the high incidence of PEP in the asymptomatic group. Endoscopists should explain the risk of ERCP\u2010related complications for asymptomatic patients before performing the procedure.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jgh3.12685","type":"journal-article","created":{"date-parts":[[2021,12,2]],"date-time":"2021-12-02T08:42:56Z","timestamp":1638434576000},"page":"1382-1390","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Endoscopic retrograde cholangiopancreatography\u2010related complications for bile duct stones in asymptomatic and symptomatic patients"],"prefix":"10.1002","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8729-9604","authenticated-orcid":false,"given":"Hirokazu","family":"Saito","sequence":"first","affiliation":[{"name":"Department of Gastroenterology Kumamoto City Hospital  Kumamoto City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Kadono","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Tsuruta Hospital  Kumamoto City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Shono","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Kumamoto Chuo Hospital  Kumamoto City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kentaro","family":"Kamikawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Saiseikai Kumamoto Hospital  Kumamoto City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Urata","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Saiseikai Kumamoto Hospital  Kumamoto City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiro","family":"Nasu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery Kumamoto Chuo Hospital  Kumamoto City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruo","family":"Imamura","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Saiseikai Kumamoto Hospital  Kumamoto City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ikuo","family":"Matsushita","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Kumamoto Chuo Hospital  Kumamoto City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuyuki","family":"Kakuma","sequence":"additional","affiliation":[{"name":"Department of Biostatics Center, Medical School Kurume University  Kurume Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuji","family":"Tada","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Kumamoto City Hospital  Kumamoto City Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,12,2]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-016-1289-7"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-0862-0346"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2016-312317"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2011.04.012"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2007.01279.x"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199609263351301"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.14604"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-015-3965-5"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.14790"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-019-01612-7"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/den.12183"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2009.10.027"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2008.5"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2012.244"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365521.2020.1853222"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0043-107615"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2011.06.033"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1067\/mge.2001.117550"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.4253\/wjge.v11.i10.515"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004640000146"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000103069.00170.9c"},{"key":"e_1_2_6_23_1","first-page":"108","article-title":"Natural history of asymptomatic bile duct stones at time of cholecystectomy","volume":"74","author":"Caddy GR","year":"2005","journal-title":"Ulster Med. 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