The Role of Stone Size in Risk Stratification for Intervention in Asymptomatic Choledocholithiasis

We read with great interest the study by Obaitan I et al. [1] published in a recent issue of Digestive Diseases and Sciences. The authors showed that endoscopic retrograde cholangiopancreatography (ERCP) for asymptomatic choledocholithiasis carries a significant risk of post-ERCP pancreatitis (PEP) compared to symptomatic cases, as demonstrated by their systematic review. Considering the invasive nature of ERCP and the potential for severe PEP [2], risk stratification is crucial when determining the necessity of the procedure, especially in asymptomatic patients. …