Positive predictive value of endosonography in the determination of presence of gallstones in the biliary tract vary to the final results of endoscopic retrograde cholangiopancreatography

Abstract

Background and Objectives:Endoscopic ultraendosonography (UES) is a sensitive technique for the diagnosis of choledocholithiasis. Our study aimed to determine the positive predictive value (PPV) of UES for the detection of choledocholithiasis.Methods:We performed a descriptive, retrospective, prospective observational, analytical study, with 150 patients who met the inclusion criteria. Endosonography and endoscopic retrograde cholangiopancreatography (ERCP) were performed in the Union of Surgeons Clinical Presentation of the city of Manizales; statistical analysis was performed using the SPSS version 21 program.Results:Fifty-five patients (36.7%) were male and 95 (63.3%) were female. Of the 150 patients positive for choledocholithiasis by UES, 29 of them (19.3%) had images compatible with the presence of bile clay, with 28 patients corroborated in ERCP, with a PPV of 96.6%. As for choledocholithiasis, it was corroborated in 139 patients in ERCP for a PPV of 92.7%.Conclusion:Endosonography has a high valor preditivo positivo for the detection of calculi and mud in the bile duct, being useful in the diagnosis of choledocholithiasis, due to its sensitivity for the detection of microlithiasis (<3 mm calculi and biliary mud), minimal invasion, and scarce morbidity, compared to other diagnostic techniques such as magnetic resonance neurography.