Common Bile Duct Stones: The Role of Preoperative, Intraoperative, and Postoperative ERCP
Bibliographic record
Abstract
The indications for endoscopic retrograde cholangiopancreatography (ERCP) to demonstrate the presence of common bile duct stones has changed in the era of laparoscopic cholecystectomy. Preoperative ERCP is indicated when there is strong evidence of common bile duct stones, ie, jaundice, cholangitis, ultrasound demonstration of a common bile duct stone, and specific enzyme elevations. Preoperative ERCP is not indicated in mild gallstone pancreatitis. ERCP and endoscopic sphincterotomy as the only treatment regimen is successful in elderly patients with severe comorbid illness who have gallstones and common bile duct stones. Intraoperative ERCP does not play a role in the era of laparoscopic cholecystectomy. Transcystic common duct stone removal or laparoscopic choledochotomy is becoming the approach to common duct stones demonstrated by intraoperative cholangiography. Postoperative ERCP is indicated when intraoperative removal of common bile duct stones is unsuccessful. It is important to note that magnetic resonance cholangiography will play an increasing role and will reduce the indications and frequency of the use of ERCP.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.009 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".