Predicting the likelihood of a persistent bile duct stone in patients with suspected choledocholithiasis: accuracy of existing guidelines and the impact of laboratory trends

Gastrointestinal Endoscopy
Megan A AdamsB Joseph Elmunzer

Abstract

Existing guidelines aim to stratify the likelihood of choledocholithiasis to guide the use of ERCP versus a lower-risk diagnostic study such as EUS, MRCP, or intraoperative cholangiography. To assess the performance of existing guidelines in predicting choledocholithiasis and to determine whether trends in laboratory parameters improve diagnostic accuracy. Retrospective cohort study. Tertiary-care hospital. Hospitalized patients presenting with suspected choledocholithiasis over a 6-year period. Assessment of the American Society for Gastrointestinal Endoscopy (ASGE) guidelines, its component variables, and laboratory trends in predicting choledocholithiasis. The presence of choledocholithiasis confirmed by EUS, MRCP, or ERCP. A total of 179 (35.9%) of the 498 eligible patients met ASGE high-probability criteria for choledocholithiasis on initial presentation. Of those, 99 patients (56.3%) had a stone/sludge on subsequent confirmatory test. Of patients not meeting high-probability criteria on presentation, 111 (34.8%) had a stone/sludge. The overall accuracy of the guidelines in detecting choledocholithiasis was 62.1% (47.4% sensitivity, 73% specificity) based on data available at presentation. The accuracy was unchanged when i...Continue Reading

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References

Sep 26, 1996·The New England Journal of Medicine·M L FreemanA M Pheley
Jan 30, 2008·Gastrointestinal Endoscopy·Frances TsePaul Moayyedi
Jan 29, 2010·Gastrointestinal Endoscopy·John T MapleJason A Dominitz
Oct 5, 2010·Gastrointestinal Endoscopy·Jean Louis Frossard, Philippe M Morel
Feb 22, 2012·Gastrointestinal Endoscopy·Michelle A AndersonJason A Dominitz
Apr 2, 2013·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·Moises Ilan Nevah RubinFrank J Lukens
Jan 2, 2014·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·Andrea AnderloniMario Del Piano

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Citations

Sep 15, 2015·Surgery·José A González-González, Roberto Monreal-Robles
Jan 21, 2016·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·C Mel Wilcox, Richard Stahl
Apr 12, 2016·Revista Española De Enfermedades Digestivas : Organo Oficial De La Sociedad Española De Patología Digestiva·Rodrigo Manuel Nárvaez RiveraHéctor Jesús Maldonado Garza
Dec 2, 2017·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Mohamed EbrahimEvangelos Kalaitzakis
Dec 6, 2018·Scandinavian Journal of Gastroenterology·Jae Keun ParkKyu Taek Lee
Jan 24, 2019·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Hyun Woo LeeJi Eun Moon
Mar 13, 2019·AJR. American Journal of Roentgenology·Jesse E ChenDavid Sarkany
May 19, 2018·United European Gastroenterology Journal·Ausra AleknaiteKestutis Strupas
Feb 28, 2017·Revista Española De Enfermedades Digestivas : Organo Oficial De La Sociedad Española De Patología Digestiva·José Alberto González González, Roberto Monreal Robles
Oct 27, 2016·The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi·Jae Geun ParkSeon Mee Park
Mar 27, 2019·Surgical Endoscopy·Chung Yao YuJames Buxbaum
Jan 11, 2017·Revista Española De Enfermedades Digestivas : Organo Oficial De La Sociedad Española De Patología Digestiva·Jacobo Dib
Oct 15, 2020·World Journal of Surgery·Isaac Tranter-EntwistleSaxon Connor
Mar 14, 2021·Gastrointestinal Endoscopy·Christopher Ko, James Buxbaum
Mar 23, 2021·Clinical Endoscopy·Yun Nah Lee, Jong Ho Moon
Jun 20, 2021·Pediatric Surgery International·Mauro Ariel CapparelliMarcelo Eugenio Barrenechea
Jul 6, 2021·Journal of Pediatric Gastroenterology and Nutrition·Reuven Zev CohenA Jay Freeman

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