{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T22:53:07Z","timestamp":1786834387262,"version":"build-2736575974"},"reference-count":31,"publisher":"Georg Thieme Verlag KG","issue":"01","funder":[{"name":"Hubei Province Major Science and Technology Innovation Project","award":["2018-916-000-008"],"award-info":[{"award-number":["2018-916-000-008"]}]},{"name":"Project of Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision","award":["2018BCC337"],"award-info":[{"award-number":["2018BCC337"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endoscopy"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:p>\n            Background\u2002A computer-assisted (CAD) system was developed to assess, score, and classify the technical difficulty of common bile duct (CBD) stone removal during endoscopic retrograde cholangiopancreatography (ERCP). The efficacy of the CAD\u200asystem was subsequently assessed through a multicenter, prospective, observational study. <\/jats:p><jats:p>\n            Method\u2002All patients who met the inclusion criteria were included. Based on cholangiogram images, the CAD system analyzed the level of difficulty of stone removal and classified it into \u201cdifficult\u201d and \u201ceasy\u201d groups. Subsequently, differences in clinical endpoints, including attempts at stone extraction, stone extraction time, total operation time, and stone clearance rates were compared between the two groups.<\/jats:p><jats:p>\n            Results\u2002173 patients with CBD stones from three hospitals were included in the study. The group classified as difficult by CAD\u200ahad more extraction attempts (7.20 vs. 4.20, P\u200a&lt;\u200a0.001), more frequent machine lithotripsy (30.4\u200a% vs. 7.1\u200a%, P\u200a&lt;\u200a0.001), longer stone extraction time (16.59 vs. 7.69 minutes, P\u200a&lt;\u200a0.001), lower single-session stone clearance rate (73.9\u200a% vs. 94.5\u200a%, P\u200a&lt;\u200a0.001), and lower total stone clearance rate (89.1\u200a% vs. 97.6\u200a%, P\u200a=\u200a0.019) compared with the group classified as easy by CAD.<\/jats:p><jats:p>\n            Conclusion\u2002The CAD system effectively assessed and classified the degree of technical difficulty in endoscopic stone extraction during ERCP. In addition, it automatically provided a quantitative evaluation of CBD and stones, which in turn could help endoscopists to apply suitable procedures and interventional methods to minimize the possible risks associated with endoscopic stone removal.<\/jats:p>","DOI":"10.1055\/a-1850-6717","type":"journal-article","created":{"date-parts":[[2022,5,12]],"date-time":"2022-05-12T09:23:02Z","timestamp":1652347382000},"page":"4-11","source":"Crossref","is-referenced-by-count":25,"title":["An artificial intelligence difficulty scoring system for stone removal during ERCP: a prospective validation"],"prefix":"10.1055","volume":"55","clinical-trial-number":[{"clinical-trial-number":"nct04719117","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Li","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China"},{"name":"Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China"},{"name":"Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youming","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China"},{"name":"Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China"},{"name":"Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Liu","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Center, Shanghai Tenth People\u2019s Hospital, Tongji University School of Medicine, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deqing","family":"Wu","sequence":"additional","affiliation":[{"name":"Digestive Endoscopy Center, Shanghai Tenth People\u2019s Hospital, Tongji University School of Medicine, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China"},{"name":"Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China"},{"name":"Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lianlian","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China"},{"name":"Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China"},{"name":"Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingting","family":"Pang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Changhai Hospital, Naval Medical University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China"},{"name":"Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China"},{"name":"Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuo","family":"Zhang","sequence":"additional","affiliation":[{"name":"Wuhan ENDOANGEL Medical Technology Company, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1882-7060","authenticated-orcid":false,"given":"Honggang","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China"},{"name":"Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China"},{"name":"Key Laboratory of Hubei Province for Digestive System Disease, Renmin Hospital of Wuhan University, 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