Predicting Factors for Common Bile Duct Stones: How Significance is Significant ?

Authors

  • Soravith Vijitpornkul Department of Surgery, Police General Hospital, Bangkok, Thailand
  • Warin Wachirapunyanukul Department of Surgery, Police General Hospital, Bangkok, Thailand

Abstract

Background: A widely adopted policy is to subject patients with cholelithiasis who is considered to be at risk for CBD stones to endoscopic retrograde cholangiography (ERCP). The criteria for ERCP were based on recognized clinical presentation, liver function test and abnormal sonographic finding. However, following such criteria, CBD stones are present in only 10-60% of patients thus unnecessary ERCP occurs in a significant number of such patients. ERCP is not a totally safe procedure. To avoid complications, patient with low risk may proceed to intraoperative cholangiography (IOC) instead of ERCP.

Objectives: To investigate the probable effective factors indicating the presence of CBD stone, thereby decreasing unnecessary ERCP.

Materials and Methods: Medical records of 220 patients at Police General Hospital with a diagnosis of acute or chronic cholecystitis or asymptomatic gallstone, between January 1992 and January 2002 were analyzed. Predictors of CBD stones were determined by univariate and multivariable analysis.

Results: Age, serum level of bilirubin, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase and the existence of jaundice, dilated bile duct, and pathologic gall bladder were found to be associated with CBD stones. Logistic regression was undertaken. Four factors were found to be significant; age (≥55 years) odds ratio 2.3; SGOT (over two fold normal) odds ratio 1.9; gallstone (multiple) odds ratio 6.8; and size of CBD (>10 mm) odds ratio 3.4.

Conclusions: A simple screening of patients at risk for CBDS can be achieved with four predictive criteria adapted for patients.

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Published

2005-06-30

How to Cite

1.
Vijitpornkul S, Wachirapunyanukul W. Predicting Factors for Common Bile Duct Stones: How Significance is Significant ?. Thai J Surg [Internet]. 2005 Jun. 30 [cited 2024 Jul. 18];26(2):50-4. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/242171

Issue

Vol. 26 No. 2 (2005): April - June

Section

Original Articles

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Articles must be contributed solely to The Thai Journal of Surgery and when published become the property of the Royal College of Surgeons of Thailand. The Royal College of Surgeons of Thailand reserves copyright on all published materials and such materials may not be reproduced in any form without the written permission.