[Performance of ASGE predictive criteria in diagnosis of choledocholithiasis in the Edgardo Rebagliati Martins Hospital].

BACKGROUND

In Peru, there are still no local studies designed for evaluating the performance of clinical guidelines designed to stratify patients according to probability of choledocholithiasis.

OBJECTIVES

To evaluate the performance of predictive criteria proposed by the American Society for Gastrointestinal Endoscopy (ASGE) in diagnosis of choledocholithiasis.

MATERIALS AND METHODS

A retrospective cohort study conducted in a hospital in Lima (Rebagliati hospital). Were included all patients with suspected choledocholithiasis who underwent endoscopic retrograde cholangiopancreatography (ERCP) between July 2014 and June 2015. Predictors of choledocholithiasis proposed by the ASGE and the diagnostic performance of the risk categories were evaluated.

RESULTS

118 patients met the inclusion criteria. In multivariate analysis, only age >55 years (OR: 3.07 [95: 1.14-8.31], p = 0.027) and the finding of stones in the common bile duct by abdominal ultrasound (OR: 1.68 [95% CI: 1.09-2.59], p = 0.018) were associated with the presence of choledocholithiasis on ERCP. The performance of the high and intermediate risk categories were 75.82% and 70.37% respectively. The performance of the high-risk category improved to 85.90% using a second set of biochemical markers.

CONCLUSIONS

The performance of the predictors and risk categories proposed by the ASGE in diagnosis of choledocholithiasis is acceptable in our hospital, according to the proposed standards; however, it must be further improved to prevent the use of diagnostic ERCP.