When Does Assessment for Bile Duct Stones Need to Be Performed Prior to Cholecystectomy for Calculus Gallbladder Disease?

Background Early diagnosis of common bile duct stone (CBDS) is crucial since its presence affects surgical therapy and acute calculous cholecystitis (ACC) has a comparable clinical picture whether or not a CBDS is present. Aim At the time of hospital admission, we sought to discover predictors of CBD stones in acute cholecystitis (AC) patients. Methods Between January 2020 and December 2022, we chose 90 patients who had typical ACC and had previously visited the emergency room at Minia University Hospital in Egypt. The 90 AC patients were split into two groups: the 63 AC patients without CBD stones and the 27 AC patients with CBD stones. The data were obtained and compared between the two groups include gender, age, history of chronic calcular cholecystitis (CCC), white blood cells (WBC), liver function tests (LFT), and common bile duct (CBD) diameter. Results By using simple logistic regression analysis for prediction of CBD stones, old age > 55 years, CBD diameter more than 6 mm and elevated liver functions including total bilirubin, direct bilirubin, serum glutamic-pyruvic transaminase (SGPT), serum glutamic-oxaloacetic transaminase (SGOT), alkaline phosphatase (ALP) and gamma-glutamyl transferase (GGT) was associated with CBD stones. By using multiple logistic regression analysis, only 2 variable showing significant association with CBD stones, including old age > 55 years (P = 0.013, odds ratio 9.26, confidence interval 1.6–53.61) and direct bilirubin (P = 0.008, Odds ratio 55.67, confidence interval 2.89–1072.35). Conclusion Age, abnormal LFTs greater than twofold, and dilated CBD >6 mm in AC patients increase the likelihood of concurrent CBDS. Knowing about these results might assist physicians develop clinical suspicions for an earlier diagnosis and improved management of CBDS.

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When Does Assessment for Bile Duct Stones Need to Be Performed Prior to Cholecystectomy for Calculus Gallbladder Disease?

Abstract: This article is part of a series on enhancing the value of care in Gastroenterology and Hepatology. Each article in this series examines specific clinical scenarios in which the value of care can be improved over a range of sub-specialties in the field.

Cited by 3 publications

References 16 publications

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Preoperative predictors of choledocholithiasis in patients presenting with acute calculous cholecystitis

Prediction of common bile duct stones in acute cholecystitis patients at time of hospital admission

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