Risk scores for choledocholithiasis perform poorly in patients with hemolytic diseases: a PEDI database report
Patients with hemolytic diseases are at increased risk for gallstone-related complications. Modified scoring systems have been developed to assess which pediatric patients would benefit from endoscopic retrograde cholangiopancreatography (ERCP) to treat choledocholithiasis. This study aimed to evalu...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-04-01
|
| Series: | Frontiers in Pediatrics |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2025.1574462/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849702250004348928 |
|---|---|
| author | Jennifer Thompson Wenly Ruan Douglas S. Fishman Matthew Giefer Kyung Mo Kim Mercedes Martinez Luigi Dall'Oglio Valerio Balassone Filippo Torroni Paola De Angelis Simona Faraci Cynthia Tsai Michael Wilsey Racha Khalaf Petar Mamula Quin Liu Yuhua Zheng Bradley A. Barth Bradley A. Barth David Michael Troendle David Michael Troendle |
| author_facet | Jennifer Thompson Wenly Ruan Douglas S. Fishman Matthew Giefer Kyung Mo Kim Mercedes Martinez Luigi Dall'Oglio Valerio Balassone Filippo Torroni Paola De Angelis Simona Faraci Cynthia Tsai Michael Wilsey Racha Khalaf Petar Mamula Quin Liu Yuhua Zheng Bradley A. Barth Bradley A. Barth David Michael Troendle David Michael Troendle |
| author_sort | Jennifer Thompson |
| collection | DOAJ |
| description | Patients with hemolytic diseases are at increased risk for gallstone-related complications. Modified scoring systems have been developed to assess which pediatric patients would benefit from endoscopic retrograde cholangiopancreatography (ERCP) to treat choledocholithiasis. This study aimed to evaluate the ability of the available criteria to determine which pediatric patients with hemolytic diseases are likely to benefit from ERCP. A secondary analysis was performed using the Pediatric ERCP Database Initiative database, which contains prospectively collected data from 1,124 ERCPs at tertiary-care institutions. We compared patients with a hemolytic disease to those without. Data was analyzed by two-tailed Fisher’s exact test and paired student t-test. Of the 47 (17.0%) patients who had a hemolytic disease, 34 (72.3%) had one or more common bile duct (CBD) stones at the time of ERCP. Among patients with hemolytic diseases, there were no differences in pre-ERCP imaging or laboratory findings between those with a CBD stone removed at ERCP and those without. Patients with hemolytic diseases did not fit the current choledocholithiasis selection criteria well: 80% in the no-stone at ERCP group met the American Society of Gastrointestinal Endoscopy high-risk criteria, and 90% met the 2016 modified Baylor pediatric criteria. Although not statistically significant, there was an increased number of adverse events in patients with hemolytic diseases. Existing ERCP criteria perform poorly in patients with hemolytic diseases, overestimating their risk of choledocholithiasis. Peri-procedure evaluations such as endoscopic ultrasound, magnetic resonance cholangiopancreatography, and intraoperative cholangiography appear underutilized and may be essential modalities in this population. |
| format | Article |
| id | doaj-art-552550aff48a4e9dba8e9b9f1945fd30 |
| institution | DOAJ |
| issn | 2296-2360 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj-art-552550aff48a4e9dba8e9b9f1945fd302025-08-20T03:17:43ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-04-011310.3389/fped.2025.15744621574462Risk scores for choledocholithiasis perform poorly in patients with hemolytic diseases: a PEDI database reportJennifer Thompson0Wenly Ruan1Douglas S. Fishman2Matthew Giefer3Kyung Mo Kim4Mercedes Martinez5Luigi Dall'Oglio6Valerio Balassone7Filippo Torroni8Paola De Angelis9Simona Faraci10Cynthia Tsai11Michael Wilsey12Racha Khalaf13Petar Mamula14Quin Liu15Yuhua Zheng16Bradley A. Barth17Bradley A. Barth18David Michael Troendle19David Michael Troendle20Department of Pediatrics, Baylor College of Medicine, Houston, TX, United StatesDepartment of Pediatrics, Baylor College of Medicine, Houston, TX, United StatesDepartment of Pediatrics, Baylor College of Medicine, Houston, TX, United StatesDepartment of Pediatrics, Ochsner Hospital for Children, New Orleans, LA, United StatesCollege of Medicine, University of Ulsan, Ulsan, Republic of KoreaDepartment of Pediatrics, Columbia University, New York City, NY, United StatesDigestive Endoscopy and Surgery Unit, Bambino Gesù Children’s Hospital (IRCCS), Rome, ItalyDigestive Endoscopy and Surgery Unit, Bambino Gesù Children’s Hospital (IRCCS), Rome, ItalyDigestive Endoscopy and Surgery Unit, Bambino Gesù Children’s Hospital (IRCCS), Rome, ItalyDigestive Endoscopy and Surgery Unit, Bambino Gesù Children’s Hospital (IRCCS), Rome, ItalyDigestive Endoscopy and Surgery Unit, Bambino Gesù Children’s Hospital (IRCCS), Rome, ItalyDepartment of Pediatrics, Baylor College of Medicine, Houston, TX, United StatesDepartment of Pediatrics, Johns Hopkins All Children’s Hospital, Saint Petersburg, FL, United StatesDepartment of Pediatrics, University of South Florida, Tampa, FL, United StatesDepartment of Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, PA, United StatesDepartment of Pediatrics, Cedars Sinai Medical Center, Los Angeles, CA, United States0Department of Pediatrics, University of Southern California, Los Angeles, CA, United States1Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, United States2Department of Pediatrics, Children’s Health, Children’s Medical Center Dallas, Dallas, TX, United States1Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, United States2Department of Pediatrics, Children’s Health, Children’s Medical Center Dallas, Dallas, TX, United StatesPatients with hemolytic diseases are at increased risk for gallstone-related complications. Modified scoring systems have been developed to assess which pediatric patients would benefit from endoscopic retrograde cholangiopancreatography (ERCP) to treat choledocholithiasis. This study aimed to evaluate the ability of the available criteria to determine which pediatric patients with hemolytic diseases are likely to benefit from ERCP. A secondary analysis was performed using the Pediatric ERCP Database Initiative database, which contains prospectively collected data from 1,124 ERCPs at tertiary-care institutions. We compared patients with a hemolytic disease to those without. Data was analyzed by two-tailed Fisher’s exact test and paired student t-test. Of the 47 (17.0%) patients who had a hemolytic disease, 34 (72.3%) had one or more common bile duct (CBD) stones at the time of ERCP. Among patients with hemolytic diseases, there were no differences in pre-ERCP imaging or laboratory findings between those with a CBD stone removed at ERCP and those without. Patients with hemolytic diseases did not fit the current choledocholithiasis selection criteria well: 80% in the no-stone at ERCP group met the American Society of Gastrointestinal Endoscopy high-risk criteria, and 90% met the 2016 modified Baylor pediatric criteria. Although not statistically significant, there was an increased number of adverse events in patients with hemolytic diseases. Existing ERCP criteria perform poorly in patients with hemolytic diseases, overestimating their risk of choledocholithiasis. Peri-procedure evaluations such as endoscopic ultrasound, magnetic resonance cholangiopancreatography, and intraoperative cholangiography appear underutilized and may be essential modalities in this population.https://www.frontiersin.org/articles/10.3389/fped.2025.1574462/fullERCPcholedocholithiasishemolytic diseasesickle cellpredictor |
| spellingShingle | Jennifer Thompson Wenly Ruan Douglas S. Fishman Matthew Giefer Kyung Mo Kim Mercedes Martinez Luigi Dall'Oglio Valerio Balassone Filippo Torroni Paola De Angelis Simona Faraci Cynthia Tsai Michael Wilsey Racha Khalaf Petar Mamula Quin Liu Yuhua Zheng Bradley A. Barth Bradley A. Barth David Michael Troendle David Michael Troendle Risk scores for choledocholithiasis perform poorly in patients with hemolytic diseases: a PEDI database report Frontiers in Pediatrics ERCP choledocholithiasis hemolytic disease sickle cell predictor |
| title | Risk scores for choledocholithiasis perform poorly in patients with hemolytic diseases: a PEDI database report |
| title_full | Risk scores for choledocholithiasis perform poorly in patients with hemolytic diseases: a PEDI database report |
| title_fullStr | Risk scores for choledocholithiasis perform poorly in patients with hemolytic diseases: a PEDI database report |
| title_full_unstemmed | Risk scores for choledocholithiasis perform poorly in patients with hemolytic diseases: a PEDI database report |
| title_short | Risk scores for choledocholithiasis perform poorly in patients with hemolytic diseases: a PEDI database report |
| title_sort | risk scores for choledocholithiasis perform poorly in patients with hemolytic diseases a pedi database report |
| topic | ERCP choledocholithiasis hemolytic disease sickle cell predictor |
| url | https://www.frontiersin.org/articles/10.3389/fped.2025.1574462/full |
| work_keys_str_mv | AT jenniferthompson riskscoresforcholedocholithiasisperformpoorlyinpatientswithhemolyticdiseasesapedidatabasereport AT wenlyruan riskscoresforcholedocholithiasisperformpoorlyinpatientswithhemolyticdiseasesapedidatabasereport AT douglassfishman riskscoresforcholedocholithiasisperformpoorlyinpatientswithhemolyticdiseasesapedidatabasereport AT matthewgiefer riskscoresforcholedocholithiasisperformpoorlyinpatientswithhemolyticdiseasesapedidatabasereport AT kyungmokim riskscoresforcholedocholithiasisperformpoorlyinpatientswithhemolyticdiseasesapedidatabasereport AT mercedesmartinez riskscoresforcholedocholithiasisperformpoorlyinpatientswithhemolyticdiseasesapedidatabasereport AT luigidalloglio riskscoresforcholedocholithiasisperformpoorlyinpatientswithhemolyticdiseasesapedidatabasereport AT valeriobalassone riskscoresforcholedocholithiasisperformpoorlyinpatientswithhemolyticdiseasesapedidatabasereport AT filippotorroni riskscoresforcholedocholithiasisperformpoorlyinpatientswithhemolyticdiseasesapedidatabasereport AT paoladeangelis riskscoresforcholedocholithiasisperformpoorlyinpatientswithhemolyticdiseasesapedidatabasereport AT simonafaraci riskscoresforcholedocholithiasisperformpoorlyinpatientswithhemolyticdiseasesapedidatabasereport AT cynthiatsai riskscoresforcholedocholithiasisperformpoorlyinpatientswithhemolyticdiseasesapedidatabasereport AT michaelwilsey riskscoresforcholedocholithiasisperformpoorlyinpatientswithhemolyticdiseasesapedidatabasereport AT rachakhalaf riskscoresforcholedocholithiasisperformpoorlyinpatientswithhemolyticdiseasesapedidatabasereport AT petarmamula riskscoresforcholedocholithiasisperformpoorlyinpatientswithhemolyticdiseasesapedidatabasereport AT quinliu riskscoresforcholedocholithiasisperformpoorlyinpatientswithhemolyticdiseasesapedidatabasereport AT yuhuazheng riskscoresforcholedocholithiasisperformpoorlyinpatientswithhemolyticdiseasesapedidatabasereport AT bradleyabarth riskscoresforcholedocholithiasisperformpoorlyinpatientswithhemolyticdiseasesapedidatabasereport AT bradleyabarth riskscoresforcholedocholithiasisperformpoorlyinpatientswithhemolyticdiseasesapedidatabasereport AT davidmichaeltroendle riskscoresforcholedocholithiasisperformpoorlyinpatientswithhemolyticdiseasesapedidatabasereport AT davidmichaeltroendle riskscoresforcholedocholithiasisperformpoorlyinpatientswithhemolyticdiseasesapedidatabasereport |