Can inflammatory indexes predict the spontaneous passage of common bile duct stones?

Abstract

Objectives

We aimed to determine whether inflammatory indexes (II), including the neutrophil–lymphocyte ratio (NLR), the C-reactive protein (CRP) to albumin ratio (CAR), the CRP–lymphocyte ratio (CLR), and the systemic immune-inflammation index (SIII) can be diagnostic for common bile duct stones (CBDSs) excretion before endoscopic retrograde cholangiopancreatography (ERCP).

Backgrounds

Because of the spontaneous clearance, it is mandatory to ascertain the presence of CBDSs before ERCP.

Methods

Retrospectively, we evaluated two groups. Group A included 96 records in which CBDSs existed in magnetic resonance cholangiopancreatography (MRCP) and ERCP. Group B included 36 records in which CBDSs existed in MRCP but not ERCP. IIs were calculated on presentation and before ERCP.

Results

Stone detection in ERCP had a 3.992-fold (95% 1.769–9.007) higher probability with a stone larger than 3.25 mm in MRCP. Before ERCP, CAR, and CLR values were higher in group A than in group B (3.88 [1.25–14.14] and 1.24 [0.50–9.66], p = 0.027 versus 8.79 [2.19–35] and 2.67 [1.02–20.05], p = 0.029, respectively). Higher CRP, CAR, and CLR values were considered significant for detecting a stone in ERCP (AUC: 0.627 [0.519–0.739], 0.625 [0.513–0.737], and 0.624 [0.514–0.734], respectively).

Conclusion

Low CRP, CAR, and CLR values might associate with the spontaneous migration of CBDS.