Brief Reports
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 7, 2005; 11(21): 3267-3272
Published online Jun 7, 2005. doi: 10.3748/wjg.v11.i21.3267
Predictors of common bile duct lithiasis in laparoscopic era
George Sgourakis, Georgia Dedemadi, Athanasios Stamatelopoulos, Emmanuel Leandros, Dionysius Voros, Konstantinos Karaliotas
George Sgourakis, Georgia Dedemadi, Athanasios Stamatelopoulos, Emmanuel Leandros, Dionysius Voros, Konstantinos Karaliotas, 2nd Surgical Department of Korgialenio-Mpenakio Red Cross Hospital, Athens, Greece; Surgical Department of Hippocration, University Hospital of Athens, Greece; Surgical Department of Areteion, University Hospital of Athens, Greece
Author contributions: All authors contributed equally to the work.
Correspondence to: George Sgourakis, MD, PhD, 11 Mantzarou str., Neo Psychiko, 15451 Athens, Greece. gsgourakis@hotmail.com
Telephone: +30-210-6716015
Received: May 25, 2004
Revised: May 26, 2004
Accepted: July 12, 2004
Published online: June 7, 2005
Abstract

AIM: To analyze retrospectively the records of 294 conse-cutive patients operated upon for gallbladder stones, to determine the predictive factors of synchronous common bile duct (CBD) stones and validate prospectively the generated model.

METHODS: The prognostic estimation of a biochemical test and ultrasonography alone to differentiate between the absence and presence of choledocholithiasis was assessed using receiver operating characteristics curve analysis. Multivariate analysis was employed using discriminant analysis for establishment of a best model. Prospective validation of the model was made.

RESULTS: Discriminant forward stepwise analysis disclosed that high values (≥ 2×normal) of SGOT, ALP, conjugated bilirubin and CBD diameter on ultrasound ≥ 10 mm were all prognostic factors of CBD lithiasis in univariate and multivariate analysis, P<0.01. History was not included in the model. Prospective validation of the model was performed by multivariate analysis using Visual General Stepwise Regression. Positive predictive value, when considering all these predictors, was 93.3%, while the negative predictive value was 88.8%. Sensitivity of the model was 96.5% and specificity 80%.

CONCLUSION: The above model can be objectively applied to predict the presence of CBD stones.

Keywords: CBD lithiasis; Predictors of CBD stones; Laparoscopic CBD exploration