• İrfan Küçük, Yusuf Yazgan, Ersin Tural, İdris Yıldırım, Tuğba Akbaş Şimşek, Çakır GüneyBaşakB0000-0003-2389-2833Department of Internal Medicine, University of Health Sciences, İstanbul, Turkey., and Mustafa Kaplan.
• Department of Gastroenterology, University of Health Sciences, İstanbul, Turkey.
• Scot Med J. 2023 Nov 1; 68 (4): 159165159-165.

ObjectivesWe 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).BackgroundsBecause of the spontaneous clearance, it is mandatory to ascertain the presence of CBDSs before ERCP.MethodsRetrospectively, 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.ResultsStone 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).ConclusionLow CRP, CAR, and CLR values might associate with the spontaneous migration of CBDS.

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