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Medical records were reviewed for demographic and clinical characteristics. Elevated bilirubin was defined as above 4 mg\/dL with\u2009&gt;\u200920% conjugated. The outcomes measured included the presence of CBD stones detected by ERCP or intraoperative cholangiography and post-cholecystectomy complications due to retained stones.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 177 patients were included in the study, with a median age of 13.4\u00a0years (IQR 9, 16.4). Sixteen patients (9%) were diagnosed with CBD stones. Elevated bilirubin, dilated CBD, and filling defects on primary imaging were strongly associated with CBD stones (50.0% vs. 9.9%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001, 62.5% vs. 9.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001, 43.8% vs. 4.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The 2019 ASGE guidelines had a sensitivity of 56.2% and a specificity of 91.1% for predicting CBD stones. Adjusting the guidelines to classify elevated bilirubin as an independent high-risk feature improved sensitivity to 68.8%, with a slight reduction in specificity to 87.6%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study suggests that the 2019 ASGE guidelines are applicable to children. Based on our findings and previous data, it seems reasonable to classify bilirubin elevation as an independent high-risk feature.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00383-025-06037-3","type":"journal-article","created":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T08:44:30Z","timestamp":1747730670000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Approach to biliary tree clearance in pediatric patients undergoing cholecystectomy: insights from a tertiary hospital"],"prefix":"10.1007","volume":"41","author":[{"given":"Tal","family":"Weiss","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yael","family":"Dreznik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maya","family":"Paran","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dragan","family":"Kravarusic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,5,20]]},"reference":[{"key":"6037_CR1","doi-asserted-by":"publisher","first-page":"748","DOI":"10.1016\/j.jpedsurg.2016.02.017","volume":"51","author":"PB Murphy","year":"2016","unstructured":"Murphy PB, Vogt KN, Winick-Ng J, McClure JA, Welk B, Jones SA (2016) The increasing incidence of gallbladder disease in children: a 20 year perspective. 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