<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2307-0420</journal-id>
<journal-title><![CDATA[Cirugía paraguaya]]></journal-title>
<abbrev-journal-title><![CDATA[Cir. parag.]]></abbrev-journal-title>
<issn>2307-0420</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Paraguaya de Cirugía]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2307-04202021000200017</article-id>
<article-id pub-id-type="doi">10.18004/sopaci.2021.agosto.17</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Factores de riesgo asociados al diagnóstico de litiasis coledociana.]]></article-title>
<article-title xml:lang="en"><![CDATA[Risk factors associated with the diagnosis of choledochal lithiasis.]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Miranda]]></surname>
<given-names><![CDATA[Christian]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Machain]]></surname>
<given-names><![CDATA[Gustavo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Melgarejo]]></surname>
<given-names><![CDATA[Sara]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bortolatto]]></surname>
<given-names><![CDATA[Leia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Negri]]></surname>
<given-names><![CDATA[Nelson]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Nacional de Asunción Facultad de Ciencias Médicas Hospital de Clínicas, Segunda Cátedra de Clínica Quirúrgica]]></institution>
<addr-line><![CDATA[San Lorenzo ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad Nacional de Asunción Facultad de Ciencias Médicas Hospital de Clínicas, Cátedra de Medicina en Imágenes]]></institution>
<addr-line><![CDATA[San Lorenzo ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2021</year>
</pub-date>
<volume>45</volume>
<numero>2</numero>
<fpage>17</fpage>
<lpage>21</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S2307-04202021000200017&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S2307-04202021000200017&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S2307-04202021000200017&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Objetivo:  determinar los factores de riesgo asociados al diagnóstico de litiasis coledociana en pacientes portadores de litiasis vesicular  Materiales y métodos: estudio retrospectivo analítico de casos y controles, comparando tres criterios de sospecha de diagnóstico de litiasis coledociana: clínicos, laboratoriales y ecográficos.  Resultados: de 146 pacientes con colecistolitiasis, 17 (11%) presentaron coledocolitiasis. Los criterios clínicos fueron inespecíficos. Hubo una relación significativa entre los niveles de bilirrubina total, directa y fosfatasa alcalina, así como del diámetro del colédoco por ecografía al comparar casos y controles. Sin embargo la sospecha a través del criterio ecográfico presentó mayor sensibilidad, especificidad y valor predictivo positivo, que los criterios clínicos y laboratoriales.  Conclusión: los valores de la bilirrubina total y directa, fosfatasa alcalina y diámetro del colédoco, representan los factores predictores y de riesgo importantes para la litiasis coledociana.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Objective: determine the risk factors associated with the diagnosis of choledochal lithiasis in patients with gallstones.  Materials and methods:  analytical retrospective cases and controls study, comparing three criteria for suspicious diagnosis of choledocholithiasis: clinical, laboratory and ultrasound criteria.  Results:  of 146 patients with cholecystolithiasis, 17 (11%) had choledocholithiasis. The clinical criteria for suspicion were nonspecific. There was a significant relationship when comparing cases and control groups between the levels of total and direct bilirubin and alkaline phosphatase, as well as the diameter of the common bile duct measured by ultrasound. However, suspicion through the ultrasound criteria shows greater sensitivity, specificity and positive predictive value than the clinical and laboratory criteria.  Conclusion: high values &#8203;&#8203;of total and direct bilirubin, alkaline phosphatase and diameter of the common bile duct represents important risk factors for choledocholithiasis.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[litiasis coledociana]]></kwd>
<kwd lng="es"><![CDATA[factores de riesgo]]></kwd>
<kwd lng="en"><![CDATA[choledocholithiasis]]></kwd>
<kwd lng="en"><![CDATA[risk factors]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cristiano]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Litiasis coledociana]]></article-title>
<source><![CDATA[Revista del Hospital El Cruce]]></source>
<year>2016</year>
<numero>18</numero>
<issue>18</issue>
<page-range>30-47</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kama]]></surname>
<given-names><![CDATA[NA]]></given-names>
</name>
<name>
<surname><![CDATA[Atli]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Doganay]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Kologlu]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Reis]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Dolapci]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Practical recommendations for the prediction and management of common bile duct stones in patients with gallstones]]></article-title>
<source><![CDATA[Surg Endosc]]></source>
<year>2001</year>
<volume>15</volume>
<numero>9</numero>
<issue>9</issue>
<page-range>942-5</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[CH]]></given-names>
</name>
<name>
<surname><![CDATA[Mo]]></surname>
<given-names><![CDATA[LR]]></given-names>
</name>
<name>
<surname><![CDATA[Lin]]></surname>
<given-names><![CDATA[RC]]></given-names>
</name>
<name>
<surname><![CDATA[Kuo]]></surname>
<given-names><![CDATA[JY]]></given-names>
</name>
<name>
<surname><![CDATA[Chang]]></surname>
<given-names><![CDATA[KK]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Rapid diagnosis of choledocholithiasis using biochemical tests in patients undergoing laparoscopic cholecystectomy]]></article-title>
<source><![CDATA[Hepatogastroenterology]]></source>
<year>2001</year>
<volume>48</volume>
<numero>39</numero>
<issue>39</issue>
<page-range>619-21</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cháves Chimbo]]></surname>
<given-names><![CDATA[MR]]></given-names>
</name>
<name>
<surname><![CDATA[Proaño Valladares]]></surname>
<given-names><![CDATA[LE]]></given-names>
</name>
</person-group>
<source><![CDATA[Descripción y evaluación de complicaciones del tratamiento de coledocolitiasis con la escala de Clavien Dindo en el Hospital Enrique Garcés y Pablo Arturo Suárez en el periodo 2006-2016]]></source>
<year></year>
<page-range>2017</page-range><publisher-loc><![CDATA[Quito, Ecuador ]]></publisher-loc>
<publisher-name><![CDATA[Universidad Central del Ecuador]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Castillo Flamain]]></surname>
<given-names><![CDATA[CR]]></given-names>
</name>
<name>
<surname><![CDATA[Ortiz Pinos]]></surname>
<given-names><![CDATA[OD]]></given-names>
</name>
<name>
<surname><![CDATA[Guamán Quizhpe]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
</person-group>
<source><![CDATA[Éxito y complicaciones de la colangiopancreatografía retrógrada endoscópica en los Hospitales Eugenio Espejo y Metropolitano de la ciudad de Quito de enero de 2011 a diciembre de 2015]]></source>
<year>2017</year>
<publisher-loc><![CDATA[Quito, Ecuador ]]></publisher-loc>
<publisher-name><![CDATA[Universidad Central del Ecuador]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pimienta Concepción]]></surname>
<given-names><![CDATA[IG]]></given-names>
</name>
<name>
<surname><![CDATA[Silva]]></surname>
<given-names><![CDATA[DM]]></given-names>
</name>
</person-group>
<source><![CDATA[Complicaciones de la colangiopancreatografía retrógrada endoscópica en pacientes con coledocolitiasis del servicio de cirugía general en el hospital Alfredo Noboa Montenegro en el período mayo 2015-abril 2016]]></source>
<year>2016</year>
<publisher-loc><![CDATA[Ambato, Ecuador ]]></publisher-loc>
<publisher-name><![CDATA[Universidad Nacional Autónoma de los Andes UNIANDES]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Duarte-Medrano]]></surname>
<given-names><![CDATA[GA]]></given-names>
</name>
<name>
<surname><![CDATA[Téllez-Ávila]]></surname>
<given-names><![CDATA[FI]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Utilidad del ultrasonido endoscópico en la evaluación del paciente con dilatación pancreatobiliar de causa no determinada]]></article-title>
<source><![CDATA[Endoscopía]]></source>
<year>2016</year>
<volume>28</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>35-42</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kawai]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Akasaka]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[Murakami]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Tada]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Koli]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Endoscopic sphincterotomy of the ampulla of Vater]]></article-title>
<source><![CDATA[Gastrointest Endosc]]></source>
<year>1974</year>
<volume>20</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>148-51</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Classen]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Demling]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Endoskopische Sphinkterotomie der Papilla Vateri und Steinextraktion aus dem Ductus choledochus [Endoscopic sphincterotomy of the papilla of vater and extraction of stones from the choledochal duct (author's transl)]]]></article-title>
<source><![CDATA[Dtsch Med Wochenschr]]></source>
<year>1974</year>
<volume>99</volume>
<numero>11</numero>
<issue>11</issue>
<page-range>496-7</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<collab>National Institutes of Health Consensus Development</collab>
<article-title xml:lang=""><![CDATA[Conference Statement on Gallstones and Laparoscopic Cholecystectomy]]></article-title>
<source><![CDATA[Am J Surg.]]></source>
<year>1993</year>
<volume>165</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>390-8</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pardo Gómez]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Litiasis vesicular]]></article-title>
<source><![CDATA[Rev Cubana Cir.]]></source>
<year>2008</year>
<volume>47</volume>
<numero>3</numero>
<issue>3</issue>
</nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Colpas Morales]]></surname>
<given-names><![CDATA[LS]]></given-names>
</name>
<name>
<surname><![CDATA[Herrera Sáenz]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Salas Díaz]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Mercado]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Morfología y composición de los cálculos biliares en 90 colecistectomías realizadas en el Hospital Universitario del Caribe. 2008-2009]]></article-title>
<source><![CDATA[Rev Cienc Biomed]]></source>
<year>2020</year>
<volume>1</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>180-4</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Pérez Ramírez]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Pérez Ramírez]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Hartmann Guilarte]]></surname>
<given-names><![CDATA[A.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Enfermedad litiásica biliar en pacientes embarazadas: Estudio Ecográfico]]></article-title>
<source><![CDATA[Rev Cubana Obstet y Ginecol.]]></source>
<year>2001</year>
<volume>27</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>124-8</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Morán Tisoc]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Cumpa Quiroz]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Vargas Cárdenas]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Astete Benavides]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Valdivia Roldán]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Características de la colangiografía retrógrada endoscópica en un centro de referencia nacional]]></article-title>
<source><![CDATA[Rev Gastroenterol Perú]]></source>
<year>2007</year>
<volume>25</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>161-7</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Barreras González]]></surname>
<given-names><![CDATA[JE]]></given-names>
</name>
<name>
<surname><![CDATA[Valle Suárez]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
<name>
<surname><![CDATA[Delgado Ramos]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[García Rodríguez]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Páez Nápoles]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Modelo predictivo preoperatorio para la litiasis coledociana en la colecistectomía videolaparoscópica]]></article-title>
<source><![CDATA[Rev Medica Electronica]]></source>
<year>2006</year>
<volume>28</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>5</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Holzinger]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Baer]]></surname>
<given-names><![CDATA[HU]]></given-names>
</name>
<name>
<surname><![CDATA[Wildi]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Vock]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Büchler]]></surname>
<given-names><![CDATA[MW]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Die Rolle der intravenösen Cholangiographie im Zeitalter der laparoskopischen Cholezystektomie: eine Renaissance? [The role of intravenous cholangiography in the era of laparoscopic cholecystectomy: is there a renaissance?]]]></article-title>
<source><![CDATA[Dtsch Med Wochenschr]]></source>
<year>1999</year>
<volume>124</volume>
<numero>46</numero>
<issue>46</issue>
<page-range>1373-8</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hoyuela]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Cugat]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Marco]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Opciones actuales para el diagnóstico y tratamiento de la coledocolitiasis]]></article-title>
<source><![CDATA[Cir Esp.]]></source>
<year>2000</year>
<volume>68</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>243-53</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Barreras González]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Ruiz Torres]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Torres Peña]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Coledocolitiasis: Opciones actuales de tratamiento laparoscópico y endoscópico]]></article-title>
<source><![CDATA[Rev Haban Cienc Méd.]]></source>
<year>2010</year>
<volume>9</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>374-84</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Dua]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Dua]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Desai]]></surname>
<given-names><![CDATA[SS]]></given-names>
</name>
<name>
<surname><![CDATA[Kuy]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Sharma]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Jechow]]></surname>
<given-names><![CDATA[SE]]></given-names>
</name>
<name>
<surname><![CDATA[McMaster]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Patel]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Kuy]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Gender based differences in management and outcomes of cholecystitis]]></article-title>
<source><![CDATA[Am J Surg.]]></source>
<year>2013</year>
<volume>206</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>641-6</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Byrne]]></surname>
<given-names><![CDATA[MF]]></given-names>
</name>
<name>
<surname><![CDATA[McLoughlin]]></surname>
<given-names><![CDATA[MT]]></given-names>
</name>
<name>
<surname><![CDATA[Mitchell]]></surname>
<given-names><![CDATA[RM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[For patients with predicted low risk for choledocholithiasis undergoing laparoscopic cholecystectomy, selective intraoperative cholangiography and postoperative endoscopic retrograde cholangiopancreatography is an effective strategy to limit unnecessary procedures]]></article-title>
<source><![CDATA[Surg Endosc]]></source>
<year>2009</year>
<volume>23</volume>
<numero>9</numero>
<issue>9</issue>
<page-range>1933-7</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
