Establishment and validation of nomogram model for predicting recurrence of common bile duct stones after ERCP lithotomy

Abstract

Abstract Background Currently, the definitive determination of risk factors linked to the recurrence of common bile duct stones remains elusive, and there is a scarcity of accurate prognostic instruments for predicting recurrence in clinical contexts. The aim of this study is to examine the high-risk factors that contribute to recurrence subsequent to endoscopic retrograde cholangiopancreatography (ERCP) stone extraction and develop a nomogram model founded on these factors. Methods This study conducted a retrospective analysis of clinical data obtained from patients who underwent ERCP stone extraction at the Department of Gastroenterology in the First Affiliated Hospital of Xinjiang Medical University during the period from January 1, 2016, to December 31, 2020. The study population consisted of 409 patients in the modeling group and 163 patients in the validation group. The Cox regression model was employed to identify independent risk factors associated with stones recurrence, which were subsequently utilized to develop a nomogram for predicting the probability of stones recurrence following ERCP. Results The Cox multivariate analysis revealed that several factors were found to be significantly associated with an increased risk of recurrence following ERCP stone removal. These factors included a body mass index (BMI) of ≥ 24 kg/m2 (hazard ratio (HR) = 2.625, 95% confidence interval (CI): 1.380–4.993, P = 0.003), a triglyceride level of ≥ 1.31 mmol/l (HR = 1.960, 95% CI: 1.106–3.473, P = 0.021), a common bile duct diameter of ≥ 1.2 cm (HR = 3.451, 95% CI: 1.359–8.766, p = 0.009), and a common bile duct stone diameter of ≥ 1 cm (HR = 6.047, 95% CI: 2.371–15.417, p < 0.001). Furthermore, a nomogram model was developed incorporating these four parameters, which demonstrated robust discriminatory power. Conclusion The prediction model that has been developed exhibits a significant degree of accuracy in predicting the recurrence of stones, thus possessing considerable significance in guiding the subsequent monitoring of patients and the implementation of preventive measures.