Preoperative clinical and paraclinical predictors of choledocholithiasis

作     者：Ali Yaghoobi Notash Javad Salimi Farzaneh Golfam Gholamreza Habibi Kamyab Alizadeh 

作者机构：Medical Sciences/University of Tehran TehranIran Department of SurgeryMedical Sciences/University of Tehran TehranIran 

出 版 物：《Hepatobiliary & Pancreatic Diseases International》 (国际肝胆胰疾病杂志（英文版）)

年 卷 期：2008年第7卷第3期

页      面：304-307页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：choledocholithiasis gallstone predicting factor diagnosis 

摘      要：BACKGROUND:Choledocholithiasis is the most common cause of obstructive jaundice and cholangitis and occurs in about 10%of patients with symptomatic *** aim of this study was to find preoperative and non-invasive tests for predicting common bile duct stones(CBDs). METHODS:Findings of clinical examination,history laboratory tests and ultrasound(US)in 60 patients with CBDs were compared retrospectively,with 60 patients with *** data were collected from medical charts The sensitivity,specificity and positive predictive value (PPV)were determined. RESULTS:The comparison between the two groups showed significant differences in anorexia,itching,dark urine subicterus(slightly elevated serum bilirubin without clinical evidence of jaundice)and jaundice appearance increased bilirubin level,aspartate aminotransferase(AST) and alanine aminotranferase(ALT),CBD diameter6 mm and stone observation under US(P0.05).The highest specificity(100%)and PPV(100%)were found in dark urine and pale colored stool,history of cholangitis,and *** paraclinical tests,alkaline phosphatase (ALP)had the highest specificity(72.1%)and PPV(12.5%) Under US,stone observation in CBD was the most important factor with a sensitivity of 94.5%,a specificity of 100%and a PPV of 100%. CONCLUSIONS:The most important factors for predicting CBDs are history of cholangitis and pancreatitis,presence of icterus,dark urine,pale colored stool,elevation of ALP and sonographic evidence of chledocholithiasis.