John Azizian, MD1, Camellia M. Dalai, MD1, James Tabibian, MD, PhD1, Formosa Chen, MD, MPH2; 1Olive View-UCLA Medical Center, Sylmar, CA; 2David Geffen School of Medicine at UCLA, Sylmar, CA
Introduction: Choledocholithiasis is a common clinical entity and, together with its potential sequelae, represents a considerable public health problem. Nevertheless, demographic predictors of choledocholithiasis have not been well-studied and instead have classically been extrapolated from predictors of cholelithiasis, namely female sex, obesity (“fat”), and middle reproductive age (“fertile” and “forty”), classically referred to as the “4 Fs”. We hypothesized that patients with choledocholithiasis have a distinct compendium of clinical predictors which are different from the classical “4 Fs”. Methods: Using a prospectively maintained database, we reviewed all endoscopic retrograde cholangiopancreatographies (ERCPs) performed at Olive View-UCLA Medical Center from November, 2015 to October, 2019. Demographic, biochemical, radiologic, and endoscopic data were abstracted, including age, race, sex, body mass index, diabetes diagnosis, peak serum bilirubin levels, the presence or absence of the gallbladder at the time of ERCP, and ERCP findings. Pre-procedural indications and post-procedural diagnoses were recorded. Logistic regression was used to identify demographic and clinical predictors of ERCP-confirmed choledocholithiasis. Results: A total of 609 ERCPs were performed during the study period. Of these, 294 were performed for suspected choledocholithiasis, which was confirmed in 251 (85.4%) of cases. BMI >30, female gender, and age >40 were not associated with ERCP-confirmed choledocholithiasis and neither were the composites of 0, 1, 2, and 3 of these risk factors in combination. A history of diabetes was associated with a decreased incidence of ERCP-confirmed choledocholithiasis, with an odds ratio of 0.34 (CI 0.13-0.86). Presence of a gallbladder at the time of ERCP was also associated with decreased incidence of ERCP-confirmed choledocholithiasis, with an odds ratio of 0.26 (CI 0.08-0.91). Reported visualization of stone and common bile duct diameter on non-invasive imaging prior to ERCP were not associated with ERCP-confirmed choledocholithiasis, nor was peak total bilirubin level. Discussion: There was no significant association between the 4 Fs, total bilirubin, reported visualization of stone and common bile duct diameter on non-invasive imaging and ERCP-confirmed choledocholithiasis.
Disclosures: John Azizian indicated no relevant financial relationships. Camellia Dalai indicated no relevant financial relationships. James Tabibian indicated no relevant financial relationships. Formosa Chen indicated no relevant financial relationships.