Predictive Factors for Synchronous Common Bile Duct Stone in Patients with Symptomatic Cholelithiasis
PHUNCHAI CHARA TCHAROENWITTHA Y A, MD*, YUDHTANA SATTA WATTHAMRONG, MD*, SATHAPORN MANATSATHIT, MD*, TAWESAK TANWANDEE,MD*, SOMCHAI LEELAKUSOLVONG, MD*, UDOM KACHINTORN, MD*, PAIROJ LEUNGROJANAKUL, MD*, SASIPRAPA BOONYAPISIT, MD*, SUPOT PONGPRASOBCHAI, MD*
Affiliation : * Division of Gastroenterology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Objective : The aim of this retrospective study was to generate an effective predictive model for bile duct stones detection by pre-operative ERCP.
Method : Twelve pre-operative clinical, biochemical and sonographic variables from 206 consecutive patients who underwent pre-operative ERCP with LC for gallstones with/without CBD stones from October 1998 to December 2000 were retrospectively analysed
Results : 143 of the 206 patients with gallstones were found to have CBD stones. The mean age was 61 (20-93) yr old, and 55.9 per cent were female. Multivariate analysis showed a high predic tive value for the presence of CBD stones in patients aged ;:::, 55 yr old (Odd radio (OR) 1.03, 95% confidence interval (95% CI) 1.01-1.05), jaundice (OR 2.7, 95% CI 1.7-4.8), elevated alkaline phos phatase (OR 1.002, 95% CI 1.000-1.005), CBD dilatation on ultrasound (OR 3.8, 95% CI 1.8-8) and CBD stone on ultrasound.
Conclusion : The important clinical presentations and investigating could allow more appro priate use of pre-operative ERCP in patients who have symptomatic gallstones with a suspected CBD stone prior to cholecystectomy.
Keywords : Predictive, Common Bile Duct Stone, Cholelithiasis, ERCP
