ArticleAnnals of gastroenterology2021
Choledocholithiasis in acute calculous cholecystitis: guidelines and beyond.
Article in Annals of gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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8 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Performance of Diagnostic Guidelines in the Evaluation of Choledocholithiasis in Patients With Acute Biliary Presentation: A Systematic Review and Meta-Analysis.World journal of surgery · 2025Pooled it
- Optimising the management of patients with cholecystitis and suspected common bile duct stones: an external validation of current prediction models.Surgical endoscopy · 2026Article
- Article
- Effect of surgical timing on postoperative outcomes in patients with acute cholecystitis after delayed percutaneous transhepatic gallbladder drainage.World journal of gastrointestinal surgery · 2024Article
- Laparoscopic common bile duct exploration is an effective, safe, and less-costly method of treating choledocholithiasis.Surgical endoscopy · 2024Article
- Accuracy of SAGES, ASGE, and ESGE criteria in predicting choledocholithiasis.Surgical endoscopy · 2022Article
- MRI Evaluation of Indomethacin Suppositories in the Prevention of Complications of Pancreatitis and Hyperamylasemia after Choledocholithiasis ERCP Based on Image Denoising Algorithm.Computational and mathematical methods in medicine · 2022Article
- Predicting common bile duct stones: Comparison of SAGES, ASGE and ESGE criteria for accuracy.Pakistan journal of medical sciencesArticle
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Authors and funding
12 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcute calculous cholecystitis (ACC) is the most frequent complication of gallstones requiring cholecystectomy. These patients may have coexisting choledocholithiasis. We aimed to evaluate the role of current guidelines for choledocholithiasis in patients with ACC.
methodsIn this retrospective study, we included all patients diagnosed with ACC between December 2018 and May 2019. These patients were substratified according to the guidelines of the American and European Societies of Gastrointestinal Endoscopy (ASGE and ESGE) as having high, intermediate, or low likelihood of choledocholithiasis, and the diagnostic performance was measured. Binomial logistic regression analysis was applied to ascertain independent risk factors for choledocholithiasis.
resultsA total of 173 patients with ACC, mean age (±standard deviation) 49.89±15.74 years and 60.1% male, were included. Sixty-three (36.4%) had confirmed choledocholithiasis. ASGE high likelihood criteria had sensitivity and specificity of 61.9% (95% confidence interval [CI] 48.8-73.9) and 83.4% (95%CI 75.4-90.0) for predicting choledocholithiasis. ESGE high likelihood criteria had sensitivity and specificity of 49.2% (95%CI 36.4-62.1) and 87.3% (95%CI 79.6-92.9). On logistic regression analysis, an alkaline phosphatase level above the upper limit of normal (P=0.003; odds ratio [OR] 4.26, 95%CI 1.66-10.96) and a dilated common bile duct on ultrasound (P=0.001; OR 9.97, 95%CI 4.65-21.36) were independent positive predictors for choledocholithiasis, while acute biliary pancreatitis was an independent negative predictor (P=0.030; OR 0.36, 95%CI 0.14-0.91).
conclusionsThe performance of the ASGE and ESGE guidelines' risk stratification criteria is inadequate in patients with ACC. We suggest the utilization of a separate predictive model for suspected choledocholithiasis in these patients.
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