Observational studyIndian journal of gastroenterology : official journal of the Indian Society of Gastroenterology2016
Scoring system to preoperatively predict choledocholithiasis.
Observational study in Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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3 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- Systematic review and meta-analysis of the 2010 ASGE non-invasive predictors of choledocholithiasis and comparison to the 2019 ASGE predictors.Clinical journal of gastroenterology · 2022Pooled it
- Risk Factors and Predictive Modeling of Occult Choledocholithiasis in Patients with Cholecystolithiasis.Gastroenterology research and practice · 2026Article
- 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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3 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe incidence of common bile duct (CBD) calculi has been reported to be 8 % to 20 % among the patients with cholelithiasis. Failure to detect CBD stones on the part of the surgeon not only fails to relieve symptoms but also subjects them to potentially life-threatening complications such as cholangitis, pancreatitis or obstructive jaundice. Modalities for detection of CBD stones have evolved over time from CBD exploration based on clinical and operative findings to intraoperative cholangiography (IOC), to endoscopic retrograde cholangiopancreaticography (ERCP) and, recently, to magnetic resonance cholangiopancreaticography (MRCP) and endoscopic ultrasonography (EUS). We felt a need for a scoring system to predict a patient population having a higher risk of choledocholithiasis so that these modern interventions can be selectively utilized.
settingThis study was performed in a tertiary care medical college hospital in a metropolitan city.
designThis is a prospective observational study.
methodsAll patients with symptomatic cholelithiasis admitted to the hospital were included. Patients were diagnosed as having choledocholithiasis either by ultrasonography (USG), computed tomography scan, MRCP, EUS or ERCP and were followed up for at least 6 weeks.
resultsThe prevalence of choledocholithiasis among the 275 patients with symptomatic biliary colic in our study was 18.9 % (n = 77). On bivariate analysis, dilated bile duct on USG (>6 mm), raised total bilirubin, raised alkaline phosphatase (ALP), raised amylase, raised SGPT and SGOT were significantly associated with choledocholithiasis (p < 0.05). On multivariate analysis also, all these factors except amylase and SGPT showed a significant correlation with choledocholithiasis (p < 0.05). These observations were used to build a scoring system consisting of four factors: dilated bile duct on USG (>6 mm), total bilirubin >2 mg/dL, ALP >190 IU/L and SGOT >40 IU/L.
conclusionA positive predictive value of 3 or more factors was over 95 %, necessitating an endoscopic intervention. A negative predictive value of the absence of any factor was 100 %, which ruled out CBD calculi. If only one or two factors are positive, then further evaluation is recommended preferably using non-minimal or minimal invasive investigations like EUS or MRCP.
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