The Accuracy of Predictive Parameters for The Presence of Common Bile Duct Stones

Authors

  • Taweewong Chulakamontri Department of Surgery, Bangkok Metropolitan Administration Medical College and Vajira Hospital, Bangkok 10300, Thailand

Abstract

Background: Common bile duct stones (CBD stones) are the most common cause of obstructive jaundice and cholangitis. Many technological refinements have been made in radiology, endoscopy and clinical laboratory testing that improve the diagnosis and evaluation of patients with CBD stones. This study was designed to determine the accuracy of the predictive parameters for preoperative diagnosis of CBD stones.

Methods: From January 1997 to September 2002, the data of 244 patients who underwent preoperative ERCP with a high index of suspicion for CBD stones based on clinical, biochemical and ultrasonographic criteria were evaluated.

Results: A raised serum alkaline phosphatase level was found to be of highest sensitivity (87%) but of low specificity (26%) indicator for CBD stones. Ultrasonography yielded the highest specificity (92%), the positive predictive value was 85 per cent and likelihood ratio positive of 6.48 for CBD stone. The combination of a raised serum alkaline phosphatase and dilated CBD on ultrasonography increased sensitivity to 91 per cent. The combination of finding CBD stone on ultrasonography and pancreatitis increased the specificity to 99 per cent for predicting presence of CBD stone.

Conclusions: A raised serum alkaline phosphatase level, CBD stone finding on ultrasonography, dilated CBD on ultrasonography and pancreatitis could be used as criteria for selective preoperative ERCP or cholangiogram in patient undergoing cholecystectomy.

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Published

2003-03-31

How to Cite

1.
Chulakamontri T. The Accuracy of Predictive Parameters for The Presence of Common Bile Duct Stones. Thai J Surg [Internet]. 2003 Mar. 31 [cited 2024 Nov. 23];24(1):33-8. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/243038

Issue

Vol. 24 No. 1 (2003): January - March

Section

Original Articles

License

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.