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Publication Metadata only Comparison of Radial Echoendoscopy and Predictive Factors in the Evaluation of Patients with Suspected Choledocholithiasis(2021-06-01) Patarapong Kamalaporn; Supphamat Chirnaksorn; Sasivimol Rattanasiri; Taya Kitiyakara; Faculty of Medicine Ramathibodi Hospital, Mahidol UniversityObjective: The aim of this study was to compare predictive factors and endoscopic ultrasound (EUS) in the diagnosis of choledocholithiasis. Materials and Methods: Patients with suspected choledocholithiasis were recruited from April 2011 to January... choledocholithiasis. Using the findings of ERCP as the gold standard, radial EUS had a sensitivity and specificity for the detection of choledocholithiasis of 90.2% and 97.4%, and for choledocholithiasis and/or common bile duct sludge 92.7% and 100%, respectivelyItem Metadata only Cystic duct diameter as an independent predictor of choledocholithiasis in patients undergoing magnetic resonance cholangiopancreatography(2025-12-01) Krisem M.; Aleenajitpong N.; Tungtrongchitr N.; Krisem M.; Mahidol UniversityPurpose: To assess the anatomy and variations of the cystic duct and biliary tree, along with their association with choledocholithiasis in patients undergoing magnetic resonance cholangiopancreatography (MRCP). Materials and methods: Patients who... for variations in biliary anatomy and the presence of biliary stones. Any discrepancies between the two radiologists were resolved through consensus. Logistic regression analysis was conducted to identify the factors associated with choledocholithiasis. ResultsPublication Metadata only Diagnostic yield of endoscopic ultrasonography in patients with intermediate or high likelihood of choledocholithiasis: A retrospective study from one university-based endoscopy center(2014-09-26) Varayu Prachayakul; Pitulak Aswakul; Patommatat Bhunthumkomol; Morakod Deesomsak; Mahidol University; Samitivej Hospital (Sukhumvit); Thammasat University Hospital© 2014 Prachayakul et al.; licensee BioMed Central Ltd. Background: Diagnosis of choledocholithiasis requires clinical manifestations and imaging examination findings suggesting a stone in the common bile duct (CBD), but these factors are not highly... sensitive or specific. The choledocholithiasis management algorithm proposed by the American Society for Gastrointestinal Endoscopy (ASGE) may not be appropriate for patients who fulfill the clinical criteria for a high likelihood of choledocholithiasisPublication Metadata only Association Between Juxtapapillary Duodenal Diverticula and Risk of Choledocholithiasis: a Systematic Review and Meta-analysis(2018-12-01) Karn Wijarnpreecha; Panadeekarn Panjawatanan; Wuttiporn Manatsathit; Wisit Cheungpasitporn; Surakit Pungpapong; Frank J. Lukens; Patompong Ungprasert; University of Nebraska Medical Center; Faculty of Medicine, Siriraj Hospital, Mahidol University; University of Mississippi Medical Center; Mayo Clinic in Jacksonville, Florida; Chiang Mai University; Bassett Medical Center© 2018, The Society for Surgery of the Alimentary Tract. Background/Objectives: Studies have suggested that the presence of juxtapapillary duodenal diverticula (JDD) could be a predisposing factor for choledocholithiasis. This systematic review... that reported odd ratios (OR) comparing the risk of choledocholithiasis among individuals with JDD versus individuals without JDD were included. Pooled OR and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance methodPublication Metadata only A same day approach for choledocholithiasis using endoscopic stone removal followed by laparoscopic cholecystectomy: A retrospective study(2009-01-01) Thawatchai Akaraviputh; Thitipong Rattanapan; Varut Lohsiriwat; Asada Methasate; Somkiat Aroonpruksakul; Darin Lohsiriwat; Mahidol UniversityObjective: The timing of minimally invasive approach of choledocholithiasis, using endoscopic retrograde cholangiopancreatography (ERCP) and laparoscopic cholecystectomy (LC), is challenging. The aim of the present retrospective study was to assess... the feasibility and safety of endoscopic stone removal for choledocholithiasis followed by same-day LC. Material and Method: Between October 2005 and February 2007, 27 patients diagnosed with choledocho-lithiasis were treated with this approach. Of these patientsItem Metadata only Urgent endoscopic retrograde cholangiopancreatography improves clinical outcomes in acute cholangitis from choledocholithiasis: a propensity score-matched study(2025-01-01) Kongsakon R.; Rugivarodom M.; Phisalprapa P.; Karaketklang K.; Charatcharoenwitthaya P.; Pausawasdi N.; Kongsakon R.; Mahidol UniversityBackground: Early endoscopic retrograde cholangiopancreatography (ERCP) with biliary drainage is recommended for acute cholangitis based on disease severity. However, the optimal timing of ERCP remains unclear. This study aimed to evaluate the impact of urgent ERCP (≤ 24 h) on clinical outcomes in patients with common bile duct (CBD) stone-related acute cholangitis. Methods: A retrospective cohort study was conducted among patients who underwent ERCP for acute cholangitis due to CBD stones between 2008 and 2017. Patients were categorized according to ERCP timing: urgent (≤ 24 h) and non-urgent (> 24 h). Outcomes included in-hospital mortality, organ failure at 72 h, length of hospital stay, procedure-related complications, and 30-day readmission. Propensity score matching (PSM) was applied to balance baseline characteristics, including age, sex, comorbidities, Charlson comorbidity index, and cholangitis severity according to the Tokyo Guidelines 2018. Results: Among 455 eligible patients, 191 matched pairs were analyzed. The mean age was 66 ± 16 years, and 50% were male. Among them, 21.5% had severe cholangitis, 40.4% moderate, and 38.1% mild disease. Following matching, patient characteristics of the two groups were balanced, except for a higher percentage of patients with moderate cholangitis in the non-urgent group. In-hospital mortality was significantly lower in the urgent ERCP group (0.5% vs 21%; adjusted OR 0.09; 95% CI: 0.01–0.73; p = 0.024). Median hospital stay was shorter (5 vs 8 days; p < 0.001), while stone clearance rates (approximately 75%), persistent organ failure, procedural complications, and readmission were comparable between groups. Subgroup analysis revealed a mortality benefit of urgent ERCP in moderate (p < 0.01) and severe (p = 0.024) cholangitis, but not in mild cases. Conclusions: Urgent ERCP within 24 h significantly reduces in-hospital mortality and shortens hospitalization in patients with moderate to severe cholangitis due to CBD stones. These findings support early intervention as a key component of management in this population.Publication Metadata only Outcomes of laparoscopic common bile duct exploration by chopstick technique in choledocholithiasis(2021-04-01) Tharathorn Suwatthanarak; Thawatchai Akaraviputh; Chainarong Phalanusitthepha; Vitoon Chinswangwatanakul; Asada Methasate; Jirawat Swangsri; Atthaphorn Trakarnsanga; Thammawat Parakonthun; Voraboot Taweerutchana; Nicha Srisuworanan; Siriraj HospitalBackground and Objectives: Laparoscopic cholecystec-tomy with common bile duct exploration (LC with LCBDE) remains the preferred technique for difficult common bile duct stone (CBDS) removal. The chopstick method uses commonly available instruments and may be cost-saving compared to other techniques. We studied the outcome of LCBDE using the chopstick technique to determine if it could be considered a first-choice method. Methods: Data from all patients that underwent LCBDE from January 1, 2012 to April 30, 2019 were retrospectively analyzed. A standard 4-port incision and CBDS permitted extraction with two laparoscopic instruments by chopstick technique via vertical choledochotomy. Demographic data, stone clearance rate, surgical outcomes, complications, and other associated factors were evaluated. Results: Thirty-two patients underwent LCBDE. The mean number of preoperative endoscopic retrograde cholangiopancreatography (ERCP) sessions was 2.4. In 65.5% of cases, the CBDS was completely removed by the chopstick technique, while 96.9% of stones were removed after using additional tools. The need for additional instruments was associated with increased age, increased numbers of stones, longer period from the latest ERCP session, and previous upper abdominal sur-gery. The conversion rate to open surgery was 28.1% and was significantly associated with a history of upper abdominal surgery. Conclusion: The chopstick technique is a good alternative and could be considered as a first-line technique in LCBDE to remove the CBDS in cases with 1 to 2 large suprapancreatic CBDS due to instrument availability, cost-effectiveness, and comparable surgical outcomes.Item Metadata only Diagnostic Value of Endoscopic Ultrasonography for Common Bile Duct Dilatation without Identifiable Etiology Detected from Cross-Sectional Imaging(2022-01-01) Pausawasdi N.; Mahidol Universitywas abnormal liver chemistry (85.5%). The mean CBD diameter was 12.2±4.1 mm. The area under the receiver operating characteristic curve (AUROC) of EUS-identified pathologies, including malignancy, choledocholithiasis, and benign biliary stricture (BBS), was 0....98 (95% confidence interval [CI], 0.95-1.00). The AUROC of EUS for detecting malignancy, choledocholithiasis, and BBS was 0.91 (95% CI, 0.85-0.97), 1.00 (95% CI, 1.00-1.00), and 0.93 (95% CI, 0.87-0.99), respectively. Male sex, alanine aminotransferase ≥3Publication Metadata only Predictive Factors for Synchronous Common Bile Duct Stone in Patients with Symptomatic Cholelithiasis(2004-02-01) Phunchai Charatcharoenwitthaya; Sathaporn Manatsathit; Somchai Leelakusolvong; Pairoj Leungrojanakul; Supot Pongprasobchai; Yudhtana Sattawatthamrong; Tawesak Tanwandee; Udom Kachintorn; Sasiprapa Boonyapisit; Mahidol University, The management of choledocholithiasis in the laparoscopic era remain debatable. Although pre-operative endoscopic cholangiopancreatography (ERCP) is available and highly accurate in the detection of CBD stones, its routine use is controversial because of itsItem Metadata only Continuous Infusion of Fluid Hydration Over 24 Hours Does Not Prevent Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis(2022-08-01) Chang A.; Pausawasdi N.; Charatcharoenwitthaya P.; Kaosombatwattana U.; Sriprayoon T.; Limsrivilai J.; Prachayakul V.; Leelakusolvong S.; Mahidol Universityage of the patients was 50.6 ± 11.6 years. The predominant indications were choledocholithiasis (48%) and malignancies (32%). Patient demographics and PEP risk factors were similar in both groups. Patients in the high-volume group received