{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T21:34:51Z","timestamp":1770327291561,"version":"3.49.0"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec>\n            <jats:title>Background and Objectives:<\/jats:title>\n            <jats:p>The prevalence of choledocholithiasis in the high-risk group of choledocholithiasis has been reported to be slightly more than 50% when there is no definite cholangitis. Replacement of diagnostic endoscopic retrograde cholangiography (ERC) with an EUS-first approach may be beneficial in these patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Materials and Methods:<\/jats:title>\n            <jats:p>In this prospective, multicenter study, patients with dilated common bile duct and serum total bilirubin levels of 1.8\u20134 mg\/dL were randomly allocated to undergo either EUS first, followed by subsequent ERC if necessary (EUS group) or ERC only (ERC group). The primary endpoint was the incidence of negative outcomes associated with a false-negative diagnosis of the choledocholithiasis or the endoscopic procedure. The secondary endpoints were the rate of diagnostic ERC and hospital stay length related to the endoscopic procedure.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Of 90 patients who were randomly assigned, the final analysis involved 42 in the EUS group and 44 in the ERC group. The negative outcomes were not significantly different between the EUS and ERC groups (2.4% <jats:italic toggle=\"yes\">vs<\/jats:italic>. 6.8%; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.62). The rate of diagnostic ERC was significantly lower in the EUS group (2.4% <jats:italic toggle=\"yes\">vs<\/jats:italic>. 47.7%; <jats:italic toggle=\"yes\">P<\/jats:italic> &lt; 0.001). The hospital stay length related to the endoscopic procedure was significantly shorter in the EUS group (1.8 \u00b1 1.0 <jats:italic toggle=\"yes\">vs<\/jats:italic>. 2.5 \u00b1 1.2 days; <jats:italic toggle=\"yes\">P<\/jats:italic> = 0.001).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion:<\/jats:title>\n            <jats:p>In selected high-risk choledocholithiasis patients, an EUS-first strategy significantly decreased the rate of diagnostic ERC and hospital stay but did not achieve a significant reduction in negative endoscopic procedure outcomes.<\/jats:p>\n          <\/jats:sec>","DOI":"10.4103\/eus-d-20-00229","type":"journal-article","created":{"date-parts":[[2021,11,3]],"date-time":"2021-11-03T16:20:49Z","timestamp":1635956449000},"page":"455-462","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["Role of EUS at high risk for choledocholithiasis without severe cholangitis and visible stone on cross-sectional imaging"],"prefix":"10.1097","volume":"10","author":[{"given":"Young Hoon","family":"Choi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoon Suk","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sang Hyub","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun Hyuk","family":"Son","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ji Kon","family":"Ryu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong-Tae","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Woo Hyun","family":"Paik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-9-20241018","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1016\/S0016-5107(02)70351-9","article-title":"National Institutes of Health State-of-the-Science Conference Statement: ERCP for diagnosis and therapy, January 14-16, 2002","volume":"56","author":"Cohen","year":"2002","journal-title":"Gastrointest Endosc"},{"key":"R2-9-20241018","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1056\/NEJM199609263351301","article-title":"Complications of endoscopic biliary sphincterotomy","volume":"335","author":"Freeman","year":"1996","journal-title":"N Engl J Med"},{"key":"R3-9-20241018","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0016-5107(98)70121-X","article-title":"Major early complications from diagnostic and therapeutic ERCP: A prospective multicenter study","volume":"48","author":"Loperfido","year":"1998","journal-title":"Gastrointest Endosc"},{"key":"R4-9-20241018","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.gie.2009.09.041","article-title":"The role of endoscopy in the evaluation of suspected choledocholithiasis","volume":"71","author":"Maple","year":"2010","journal-title":"Gastrointest Endosc"},{"key":"R5-9-20241018","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1016\/j.gie.2018.10.001","article-title":"ASGE guideline on the role of endoscopy in the evaluation and management of choledocholithiasis","volume":"89","author":"Buxbaum","year":"2019","journal-title":"Gastrointest Endosc"},{"key":"R6-9-20241018","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1055\/a-0862-0346","article-title":"Endoscopic management of common bile duct stones: European Society of Gastrointestinal Endoscopy (ESGE) guideline","volume":"51","author":"Manes","year":"2019","journal-title":"Endoscopy"},{"key":"R7-9-20241018","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1016\/j.gie.2017.01.039","article-title":"Accuracy of ASGE high-risk criteria in evaluation of patients with suspected common bile duct stones","volume":"86","author":"He","year":"2017","journal-title":"Gastrointest Endosc"},{"key":"R8-9-20241018","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1055\/a-1117-3451","article-title":"Clinical utility of ESGE and ASGE guidelines for prediction of suspected choledocholithiasis in patients undergoing cholecystectomy","volume":"52","author":"Jagtap","year":"2020","journal-title":"Endoscopy"},{"key":"R9-9-20241018","doi-asserted-by":"crossref","first-page":"290","DOI":"10.5009\/gnl16052","article-title":"Diagnostic value of endoscopic ultrasonography in symptomatic patients with high and intermediate probabilities of common bile duct stones and a negative computed tomography scan","volume":"11","author":"Jeon","year":"2017","journal-title":"Gut Liver"},{"key":"R10-9-20241018","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1186\/1471-230X-14-165","article-title":"Diagnostic yield of endoscopic ultrasonography in patients with intermediate or high likelihood of choledocholithiasis: A retrospective study from one university-based endoscopy center","volume":"14","author":"Prachayakul","year":"2014","journal-title":"BMC Gastroenterol"},{"key":"R11-9-20241018","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1007\/s00534-012-0561-3","article-title":"TG13 guidelines for diagnosis and severity grading of acute cholangitis (with videos)","volume":"20","author":"Kiriyama","year":"2013","journal-title":"J Hepatobiliary Pancreat Sci"},{"key":"R12-9-20241018","doi-asserted-by":"crossref","first-page":"E160","DOI":"10.1055\/s-0034-1377384","article-title":"Prospective, randomized, comparative study of delineation capability of radial scanning and curved linear array endoscopic ultrasound for the pancreaticobiliary region","volume":"2","author":"Kaneko","year":"2014","journal-title":"Endosc Int Open"},{"key":"R13-9-20241018","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1002\/hep.1840200233","article-title":"Biliary sludge: Curiosity or culprit?","volume":"20","author":"Lee","year":"1994","journal-title":"Hepatology"},{"key":"R14-9-20241018","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1016\/j.gie.2009.10.027","article-title":"A lexicon for endoscopic adverse events: Report of an ASGE workshop","volume":"71","author":"Cotton","year":"2010","journal-title":"Gastrointest Endosc"},{"key":"R15-9-20241018","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1055\/s-2007-966264","article-title":"Endoscopic ultrasound versus endoscopic retrograde cholangiography for patients with intermediate probability of bile duct stones: A randomized trial comparing two management strategies","volume":"39","author":"Polkowski","year":"2007","journal-title":"Endoscopy"},{"key":"R16-9-20241018","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.gie.2014.12.023","article-title":"Predicting the likelihood of a persistent bile duct stone in patients with suspected choledocholithiasis: Accuracy of existing guidelines and the impact of laboratory trends","volume":"82","author":"Adams","year":"2015","journal-title":"Gastrointest Endosc"},{"key":"R17-9-20241018","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1067\/mge.2001.117550","article-title":"Risk factors for post-ERCP pancreatitis: A prospective, multicenter study","volume":"54","author":"Freeman","year":"2001","journal-title":"Gastrointest Endosc"},{"key":"R18-9-20241018","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1038\/ajg.2008.5","article-title":"Risk factors for ERCP-related complications: A prospective multicenter study","volume":"104","author":"Wang","year":"2009","journal-title":"Am J Gastroenterol"},{"key":"R19-9-20241018","doi-asserted-by":"crossref","first-page":"S165","DOI":"10.1016\/S0016-5107(02)70005-9","article-title":"Epidemiology and natural history of common bile duct stones and prediction of disease","volume":"56","author":"Ko","year":"2002","journal-title":"Gastrointest Endosc"},{"key":"R20-9-20241018","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1016\/j.dld.2013.02.005","article-title":"Endoscopic retrograde cholangiopancreatography for suspected choledocholithiasis: Testing the current guidelines","volume":"45","author":"Rubin","year":"2013","journal-title":"Dig Liver Dis"},{"key":"R21-9-20241018","doi-asserted-by":"crossref","first-page":"4613","DOI":"10.1007\/s00464-016-4799-8","article-title":"An assessment of existing risk stratification guidelines for the evaluation of patients with suspected choledocholithiasis","volume":"30","author":"Suarez","year":"2016","journal-title":"Surg Endosc"},{"key":"R23-9-20241018","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/S0016-5107(99)70047-7","article-title":"Does cholecystectomy after endoscopic sphincterotomy prevent the recurrence of biliary complications?","volume":"49","author":"Lai","year":"1999","journal-title":"Gastrointest Endosc"}],"container-title":["Endoscopic Ultrasound"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.4103\/EUS-D-20-00229","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,18]],"date-time":"2024-10-18T01:08:27Z","timestamp":1729213707000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.4103\/EUS-D-20-00229"}},"subtitle":["A multicenter randomized clinical trial"],"short-title":[],"issued":{"date-parts":[[2021,11]]},"references-count":22,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.4103\/eus-d-20-00229","relation":{},"ISSN":["2303-9027"],"issn-type":[{"value":"2303-9027","type":"print"}],"subject":[],"published":{"date-parts":[[2021,11]]}}}