ArticleAnnals of Saudi medicine
A scoring system for the prediction of choledocholithiasis: a prospective cohort study.
Article in Annals of Saudi medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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5 citing papers in PubMed, 17 citations in OpenAlex.
- Predictive Value of Transabdominal Ultrasonography in Detecting Extrahepatic Bile Duct Obstructive Lesions Compared with Endoscopic Retrograde Cholangiopancreatography.Pakistan journal of medical sciences · 2025Article
- Machine learning models compared to existing criteria for noninvasive prediction of endoscopic retrograde cholangiopancreatography-confirmed choledocholithiasis.Liver research (Beijing, China) · 2021Article
- Factors related to the spontaneous passage of common bile duct stones through the papilla: a single-center retrospective cohort study.The Journal of international medical research · 2021Article
- Health informatics publication trends in Saudi Arabia: a bibliometric analysis over the last twenty-four years.Journal of the Medical Library Association : JMLA · 2021Article
- Combination of CT findings can reliably predict radiolucent common bile duct stones: a novel approach using a CT-based nomogram.European radiology · 2019Article
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
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Abstract
backgroundTechniques for diagnosing choledocholithiasis pose significant morbidity and mortality risks.
objectivesWe aimed to develop and validate a clinical scoring system for predicting choledocholithiasis.
designData from a prospectively maintained database of all patients with gallstones.
settingPatients were admitted to the general surgery department of a military hospital. PATIENTS AND
methodsWe enrolled consecutive patients with symptomatic gallstones, biliary pancreatitis, obstructive jaundice, or cholangitis, who subsequently underwent biochemical testing and ultrasonography. A predictive model was developed from a scoring system using their imaging and laboratory data. Endoscopic retrograde cholangiopancreatography (ERCP) or intraoperative cholangiography were used for confirmatory diagnoses. The predictive efficacy of the scoring system was validated using a retrospective cohort of 272 patients.
main outcome measuresPredictive accuracy of the scoring system.
resultsWe enrolled 155 patients in the development group. The common bile duct diameter, alkaline phosphatase of >=200 IU, elevated bilirubin levels, alanine transaminase of >=220 IU, and male age of >=50 years were significantly associated with choledocholithiasis and were included in the scoring system. Ninety-six patients (35%) had scores of >=8 (high risk), 86 patients (32%) had scores of 4-7 (intermediate risk), and 27 patients (10%) had scores of 1-3 (low risk). In the validation cohort, the positive predictive value for a score of >=8 was 91.7%, and the scoring system had an area under the curve of 0.896.
conclusionScores of >=8 were strongly correlated with choledocholithiasis in the developmental and validation groups, which indicates that our scoring system may be useful for predicting the need for therapeutic ERCP. However, prospective validation in a large multicenter cohort is needed to fully understand the benefits of the system. LIMITATIONS: The retrospective validation cohort might have introduced selection and observational biases. The study may have been underpowered because of the sample size of the developmental cohort. The delay between admission and the time of ERCP theoretically may have increased the number of negative ERCP results, but our false negative rate for ERCP was consistent with the previously reported rates.
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