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Biliary sludge and microlithiasis represent specific morphologies of biliary stones,1 the two terms were often confused in literature, complicating the comparison of studies and therapeutic strategies.2 Therefore, we read with great interest the study by Żorniak et al,3 which proposed a unified and consensual morphological definition of the size and echogenicity for biliary sludge (hyperechoic material without acoustic shadowing) and microlithiasis (diameter ≤5 mm with acoustic shadowing) for the first time. A recent retrospective cohort study based on this definition showed that biliary sludge and microlithiasis could cause a gallstone-equivalent clinical pancreatitis outcome.4 However, it only described morphological findings in endoscopic ultrasonography (EUS), there remained a lack of studies on morphological consistency between preoperative EUS and endoscopic retrograde cholangiopancreatography (ERCP) in diagnosing biliary sludge and microlithiasis. To address this gap, we conducted a preliminary study to further verify the morphology of stones observed by EUS from an endoscopic (ERCP) perspective.
A total of 807 and 1051 patients reported various forms of bile duct stones (including biliary sludge, microlithiasis, cholangiolithiasis and cholangitis) through EUS or ERCP were retrospectively collected from patients who were admitted to the Department of Gastroenterology at the First Affiliated Hospital of Anhui Medical University from October …
Footnotes
CS, JH and BB are joint first authors.
Contributors CS, JH and BB are joint first authors. CS, JH, JB and QM contributed to the study design. CS and BB wrote the initial manuscript draft. CS, JH, BB and HD analysed the data. SL, LC and ZX had important intellectual input and supervised. JB and QM critically revised the manuscript and contributed to manuscript editing. All authors read and approved the final version of the article.
Funding This study was supported by the National Natural Science Foundation of China (grant no.82170564).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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