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In patients with gallstone pancreatitis, presence or absence of retained common bile duct (CBD) stones affects clinical management strategy. Several years ago, in a single-center retrospective study, researchers in New York City identified five variables that predicted presence of CBD stones: duct size ≥9 mm, γ-glutamyl transferase ≥350 U/L, alkaline phosphatase ≥250 U/L, total bilirubin ≥3 mg/dL, and direct bilirubin ≥2 mg/dL (J Gastrointest Surg 2009; 13:2183). Now, the researchers have applied these criteria prospectively to 84 patients hospitalized with gallstone pancreatitis; patients with cholangitis were excluded.
Sixteen patients were found to have CBD stones:
Of 36 patients with none of the five criteria (score, 0), none had CBD ston…