The application value of preoperative magnetic resonance cholangiopancreatography in predicting the success of endoscopic retrograde cholangiopancreatography stone removal

Background and purpose Common bile duct stones (CBDS) are a common disease. Endoscopic retrograde cholangiopancreatography (ERCP) is currently recognized as the preferred treatment method for CBDS. However, there are cases that cannot be removed through ERCP. Therefore, the aim of this study is to explore the value of magnetic resonance cholangiopancreatography (MRCP) in assessing the success of CBDS removal through ERCP. Patients and methods A total of 432 CBDS patients were include in this study. According to whether the stone removal was successful in ERCP, the patients were divided into the successful stone removal group and the failed stone removal group. The differences in MRCP-related parameters between the two groups were analyzed. Results This multi-center study included a total of 175 male CBDS patients and 257 female CBDS patients. A total of 395 CBDS patients successfully removed stones through ERCP, with a success rate of 91.44%. There were significant differences in the stone diameter ( p 0.001), the widest diameter of the CBD ( p 0.001), and the widest diameter of the CBD/stone diameter ( p 0.001) between success group and failure group. But, there was no significant difference in the number of single stone patients ( p = 0.174). Binary multivariate logistic regression analysis revealed that only stone diameter 15 mm was significantly associated with ERCP stone extraction failure (OR = 11.229, 95% CI: 1.576–80.033, p = 0.016). ROC curve analysis demonstrated that this cutoff value had excellent predictive performance, with an area under the curve (AUC) of 0.94, a maximum Youden’s index of 0.749, 100% sensitivity, and 75% specificity. Conclusion The results of this study confirm that preoperative MRCP plays a significant role in assessing the success of ERCP stone removal in CBDS patients. The stone diameter 15 mm was identified as an independent risk factor.