Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastrointest Surg. Nov 27, 2026; 18(11): 125793
Published online Nov 27, 2026. doi: 10.4240/wjgs.125793
Published online Nov 27, 2026. doi: 10.4240/wjgs.125793
Imaging-independent model for predicting choledocholithiasis in acute biliary pancreatitis
Simon Sirtl, Arlett Patricia Gloria Schäfer, Katharina Bretthauer, Eric Hohmann, Mali Junge, Mahmood Ahmad, Jakob Vielhauer, Anna Hausdorf, Max O Hubert, Jörg Schirra, Christian Schulz, Georg Beyer, Ujjwal M Mahajan, Julia Mayerle, Hans C Stubbe, Department of Medicine II, LMU University Hospital, Munich 81377, Bavaria, Germany
Raul Velamazán, Department of Gastroenterology, Hospital Clínico Universitario Lozano Blesa, Zaragoza 50009, Aragon, Spain
Raul Velamazán, IIS (Instituto de Investigacion Sanitaria), Zaragoza 50009, Aragon, Spain
Raul Velamazán, Centro de Investigacion Biomedica en Red de Enfermedades Hepaticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid 28029, Spain
Ughur Aghamaliyev, Department of General, Visceral, and Transplantation Surgery, LMU Uni
Michal Żorniak, Department of Endoscopy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice 44-102, Poland
Co-first authors: Simon Sirtl and Arlett Patricia Gloria Schäfer.
Author contributions: Sirtl S and Schäfer APG designed, contributed to the research, analyzed data and wrote the paper; Stubbe HC designed the research, analyzed the data and contributed to the paper writing; Velamazán R wrote the paper, designed and contributed to the analysis; Bretthauer K, Hohmann E, Junge M, Ahmad M, Vielhauer J, Hausdorf A, Hubert MO, Aghamaliyev U, Schirra J, Schulz C, Żorniak M, Beyer G, Mahajan UM, Mayerle J contributed to the research; all authors reviewed the manuscript.
AI contribution statement: AI (Chat-GPT, GPT-5.6 Luna) was used in parts of the manuscript solely for language refinement and optimizing readability. All authors carefully reviewed and verified all AI-assisted outputs and take full responsibility for the scientific content of the manuscript.
Institutional review board statement: The study was reviewed and approved by the ethics committee of the LMU, No. 22-0084/22-0073.
Informed consent statement: Due to the retrospective nature of the study, the LMU ethics committee waived the requirement for obtaining informed consent.
Conflict-of-interest statement: The authors declare no conflict of interest.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The source code for the analysis is freely available under the MIT open-source license at https://github.com/hcstubbe/bile. Anonymized data are available upon reasonable request.
Corresponding author: Simon Sirtl, MD, Department of Medicine II, LMU University Hospital, Marchioninistraße 15, Munich 81377, Bavaria, Germany. simon.sirtl@med.uni-muenchen.de
Received: July 17, 2026
Revised: August 11, 2026
Accepted: October 20, 2026
Published online: November 27, 2026
Processing time: 119 Days and 9.9 Hours
Revised: August 11, 2026
Accepted: October 20, 2026
Published online: November 27, 2026
Processing time: 119 Days and 9.9 Hours
Core Tip
Core Tip: We developed an imaging-independent prediction model for choledocholithiasis in acute biliary pancreatitis using only routinely available admission clinical and laboratory variables. Unlike existing approaches, the model intentionally excluded common bile duct diameter to avoid observer-dependent imaging variability. It achieved high sensitivity and a low false rule-out rate, supporting its potential role as an early triage tool. Although not suitable as a stand-alone indication for endoscopic retrograde cholangiopancreatography, it may help prioritize further diagnostic evaluation, especially where en