ASGE Predictors for the Diagnosis of Choledocholithiasis: Validation in a Public Hospital of Merida, Yucatan, México

Abstract

Background:: Choledocholithiasis is defined as the presence of calculus in the biliary tract, and is one of the main complications of cholelithiasis. Its prevalence among the Mexican pop-ulation is 14%. Objective:: To determine the validity of predictors of choledocholithiasis in patients attending the Hospital Agustin O’Horan from January 2019 to December 2020. Methods:: This was an observational, analytical, and retrospective study. It included patients with a diagnosis of choledocholithiasis, and it evaluated the sensitivity, specificity, as well as positive and negative predictive values for risk criteria of the American Society for Gastrointestinal Endoscopy (ASGE) Results:: Ninety-six medical histories were analyzed. Ninety were from women and six from males (94% and 6% respectively), and the average age was 40 years. The registry shows an increase of serum ALP, AST, and ALT in 98% of the reports, and elevated levels of bilirubin in 19% by 1.3-4 mg/dl, and 76% by >4mg/dl of them. Moreover, the records showed pancreatitis and cholangitis (8% each one). The ultrasound reports indicates that 96% of the patients had a choledochal cyst higher than 5 mm, while 54% had a choledochal litho. Sensitivity and specificity of ASGE criteria for the diagnosis of choledocholithiasis was 96.6% and 45.5% respectively, and a Positive Predictive Value of 16% and a Negative Predictive Value of 99%. Conclusion:: It is considered that the diagnostic accuracy test of the ASGE criteria for the diagnosis of choledocholithiasis is high.