Choledocolithiasis predictors in high-risk population subjected to endoscopic retrograde pancreatocholangiography at "Hospital Nacional Arzobispo Loayza"

• Published in: Revista de gastroenterología del Perú Vol. 27; no. 2; pp. 161 - 171
• Main Authors: Parra Pérez, V, Vargas Cárdenas, G, Astete Benavides, M, Valdivia Roldán, M, Morán Tisoc, L, Nuñez Calixto, N, Chávez Rossell, M, Mayurí Bravo De Rueda, C
• Format: Journal Article
• Language: Spanish
• Published: Peru 01-04-2007
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Cholangiopancreatography, Endoscopic Retrograde; Choledocholithiasis - diagnostic imaging; Choledocholithiasis - etiology; Cross-Sectional Studies; Female; Hospitals; Humans; Male; Middle Aged; Predictive Value of Tests; Prospective Studies; Risk Factors
• ISSN: 1022-5129

The choledocholithiasis is a frequent complication of gallstone disease. The endoscopic retrograde cholangiopancreatography (ERCP) is suitable for its diagnosis and treatment. That approach has both significative morbility and mortality so others methods of diagnosis have been proposed such as intraoperatorycholangiography (IOC) and magnetic resonance cholangiography (MRC), reserving ERCP only for therapy purpose.
Verify the utility of choledocholithiasis predictors described in literature
This study is a correlational observational transversal prospective approach. It was performed at the Arzobispo Loayza Hospital from August 2004 to January 2005. Many clinical, biochemical and ecographyc predictors of choledocholithiasis were analyzed in 151 patient underwent to ERCP. In all peopleunder study and analyzing separately patients underwent to cholecystectomy or not previous to ERCP, it was identified some risk factors for choledocholithiasis by means of both univariate and multivariate analysis.
The univariate analysis showed a relationships among age, icterus, cholangytis, direct bilirrubin, amylase, lactic deshidrogenasa, ductal dilatation (>8 mm) and choledocholithiasis. In all groups, the multivariate analysis determined that ductal dilatation by ecography was the unique predictor for choledocholithiasis in the group of patients postoperated.
None single indicator was able to predict with accuracy the choledocholithiasis. However, the parameters described in the literature are useful in our country.