{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T19:34:40Z","timestamp":1757619280418,"version":"3.44.0"},"reference-count":21,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Frontline Gastroenterol"],"accepted":{"date-parts":[[2015,5,30]]},"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Endoscopic retrograde cholangiopancreatography (ERCP) is currently the method of choice for the postoperative evaluation of suspected bile duct stones seen on intraoperative cholangiogram (IOC); however, the sensitivity of IOC for identifying biliary pathology is unclear, with studies reporting false positive rates between 30% and 60%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Evaluate the sensitivity of IOC for biliary pathology, using ERCP with sphincterotomy and balloon sweep as gold standard.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Retrospective cohort study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Tertiary medical centre.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients<\/jats:title>\n                  <jats:p>130 consecutive patients (age 51.3\u00b11.7\u2005years, 69.2% women) who underwent ERCP for the evaluation of abnormalities identified on IOC between 2005 and 2013.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Interventions<\/jats:title>\n                  <jats:p>Endoscopic retrograde cholangiopancreatography<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main outcome measurements<\/jats:title>\n                  <jats:p>Sensitivity of IOC, identify predictors of positive postoperative ERCP and ERCP-related complications.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>ERCP was successful in all 130 subjects. ERCP-related adverse events occurred in six (4.3%) patients, including self-limited post-sphincterotomy bleeding in three (2.3%) and mild post-ERCP pancreatitis in three (2.3%). Overall, 41 (31.5%) patients had normal cholangiogram at time of ERCP. Finding of a filling defect on IOC was the only predictor for the presence of common bile duct stones on postoperative ERCP (OR 3.3, 95% CI 1.0 to 10.8, p=0.05).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Limitations<\/jats:title>\n                  <jats:p>Retrospective study design.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Nearly one-third of patients with abnormal IOC had a normal postoperative ERCP. Significant pathology could have been missed in 1\/130 patients. Based on these findings, we believe the use of less-invasive diagnostic modalities may be used in place of ERCP in patients with suspected choledocholithiasis on IOC.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/flgastro-2015-100597","type":"journal-article","created":{"date-parts":[[2015,6,16]],"date-time":"2015-06-16T23:00:38Z","timestamp":1434495638000},"page":"105-109","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Evaluation of patients with abnormalities on intraoperative cholangiogram: time to abandon endoscopic retrograde cholangiopancreatography as the initial follow-up study"],"prefix":"10.1136","volume":"7","author":[{"given":"Jason G","family":"Bill","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Washington University School of Medicine, St Louis, Missouri, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4992-3696","authenticated-orcid":false,"given":"Vladimir M","family":"Kushnir","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Washington University School of Medicine, St Louis, Missouri, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel K","family":"Mullady","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Washington University School of Medicine, St Louis, Missouri, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faris M","family":"Murad","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Washington University School of Medicine, St Louis, Missouri, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riad R","family":"Azar","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Washington University School of Medicine, St Louis, Missouri, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffery J","family":"Easler","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Washington University School of Medicine, St Louis, Missouri, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dayna S","family":"Early","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Washington University School of Medicine, St Louis, Missouri, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven A","family":"Edmundowicz","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Washington University School of Medicine, St Louis, Missouri, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,6,16]]},"reference":[{"key":"2025090708302369000_7.2.105.1","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1177\/000313480006600502","article-title":"Management of choledocholithiasis in the era of laparoscopic surgery","volume":"66","author":"Hawasli","year":"2000","journal-title":"Am Surg"},{"key":"2025090708302369000_7.2.105.2","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1007\/s004640000146","article-title":"Routine vs \u201con demand\u201d postoperative ERCP for small bile duct calculi detected at intraoperative cholangiography. 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