Abnormal Liver Function Tests Research Articles

196 Liver function test abnormalities in people with cystic fibrosis treated with elexacaftor/tezacaftor/ivacaftor

196 Liver function test abnormalities in people with cystic fibrosis treated with elexacaftor/tezacaftor/ivacaftor

Acute Liver Failure in Children: Clinical Presentation and Management

Introduction: Acute liver failure (ALF) is an uncommon condition in which rapid deterioration of liver functions results in coagulopathy, usually with an international randomized ratio (INR) of greater than 1.5 which is not corrected by a single dose of vitamin K, the condition associated with encephalopathy or INR 2 or more and is not corrected by a single dose of vitamin K without encephalopathy. Acute liver failure (ALF) is a life-threatening condition characterized by jaundice, encephalopathy and coagulopathy leading to multi-organ failure in a patient with no prior history of liver disease and carries a very high mortality rate. Objective: To study the clinical presentation and management of acute liver failure (ALF) among children admitted to Jaffer Ibn Oaf Teaching Hospital in Khartoum, Sudan during the year 2019. Methods: A descriptive cross sectional and hospital-based study conducted in all children presented to Jaffer Ibn Oaf Teaching Hospital in Khartoum, Sudan with acute liver failure during January to December 2019. The study sample was calculated by total coverage of all patients. Study questionnaires captured mainly quantitative data. The data was reviewed and analyzed into descriptive and inferential statistics by using computerized software package for window statistical package for social science (SPSS) version 21. Results: 47 children had acute liver failure were included. The prevalence of pediatric ALF in the studied hospital was 8.95%. The majority of participants were males and were 2 months to 14 years of age. All patients (100%) presented with jaundice, 38 (80.9%) had weakness and fatigue, 23 (48.9%) developed encephalopathy, mainly grade-I, 19 (40.0%) had nausea, 16 (34%) had ascites and 7 (14.8%) had seizures. INR was prolonged in all patients. Most patients had abnormal liver function tests. Almost all patient received vitamin K injection. Many patients needed pressure and circulation support and special treatment based on the underline cause. The mortality rate was 34% and 29.8% of the patients were recovered without liver transplantation. Statistically significant best outcome associated with elder age and hepatic encephalopathy grade-1. Poor outcome was significantly frequent among patients with anemia, thrombocytopenia, leukocytosis, hypokalemia and high liver enzymes. Conclusion: Pediatric acute liver failure mainly presented with jaundice, weakness and fatigue, grade-I encephalopathy, nausea, ascites and seizures. Treatment was mainly supportive with some patient needed treatment for the underlying causes. Poor outcome associated with anemia, thrombocytopenia, leukocytosis, hypokalemia and high liver enzymes.

P19 A case of pyrexia of unknown origin - wrong way round!

P19 A case of pyrexia of unknown origin - wrong way round!

"Long-term follow-up and prognosis of celiac hepatitis".

Celiac disease has been associated with abnormal liver function tests at diagnosis that usually resolve with a gluten-free diet (GFD). The aim of this study was to assess the evolution of liver involvement and possible long-term complications in patients on a GFD. Retrospective and single-center study, which included all individuals with Celiac disease followed in specialized consultation in a tertiary referral hospital. A total of 162 patients were included, most of them female (77.8%) with a median age of 24 years (IQR, 7-39). Seventy-four (45.7%) patients had abnormal liver function tests at diagnosis. These individuals had higher anti-tissue transglutaminase IgA (tTG-IgA) antibody titers (126 vs. 29 IU/L; P = 0.003). There were no significant differences in the Marsh classification ( P = 0.599). During follow-up, most celiac hepatitis patients had normalization of liver function tests and tTG-IgA antibodies. At the last follow-up, all the patients had fibrosis-4 index <2.4 and an aspartate aminotransferase-to-platelet ratio index score <0.6. Vibration-controlled transient elastography showed values <6.4 kPa in all cases. On the other hand, it was found that 42.9% of the individuals had a controlled attenuation parameter >206.5 db/m. In our cohort, liver function tests normalized in the vast majority of celiac hepatitis patients on a GFD, with no progression to chronic liver disease. It should be noted the high number of individuals who present hepatic steatosis during follow-up, which may be related to a diet that tends to be hyperlipidemic and hypercaloric.

Graft-Versus-Host Disease Associated Post-operative Complications After Pelvic Reconstructive Surgery: A Case Report

Introduction: Graft-versus-host disease (GVHD) can occur after allogeneic bone marrow transplantation (BMT) and can affect the skin, gastrointestinal tract, lungs, liver, and vulvovaginal areas. Case Presentation: This case report described a 65-year-old multiparous patient with myelodysplastic syndrome who underwent a matched unrelated donor transplant approximately 3 years before her surgery. After her BMT she developed GVHD. She underwent anterior and posterior repair and uterosacral ligament suspension for stage III post-hysterectomy vaginal vault prolapse. Her postoperative course was complicated by mental status changes, abnormal liver function tests, and increasing abdominal distention. All her post-operative symptoms were resolved with conservative management. Conclusions: This case presentation highlights the potential atypical post-operative course of BMT patients with GVHD. The management of patients with GVHD relies heavily on the early involvement of hematologists.

Minimal Risk of Drug-Induced Liver Injury With Molnupiravir and Ritonavir-Boosted Nirmatrelvir

Minimal Risk of Drug-Induced Liver Injury With Molnupiravir and Ritonavir-Boosted Nirmatrelvir

Incorporation of liver chemistry score in predicting survival of liver-involved advanced gastric cancer patients who received palliative chemotherapy.

Gastric cancer liver metastasis (GCLM) patients usually accompany by abnormal serum liver function tests (LFTs) more or less; however, the prognostic value of LFTs is not fully understood. This study aimed to develop a liver chemistry score (LCS) based on LFTs and incorporate it into prognosis determination for GCLM patients who received palliative chemotherapy. Data were derived from hospitalized GCLM patients in two general hospitals in China. LCS was generated based on the results of LFTs by LASSO regression. Cutoff value of the score was determined by restricted cubic spline. The score was then incorporated into Cox regression analysis to construct a predictive nomogram; the model was then evaluated internally and externally by AUC of time-dependent receiver operating characteristic curves (ROC) and calibration curves. Three hundred and thirty-six and 72 patients were included in development and validation cohort, respectively. LASSO regression analysis in development cohort finally reached a two-parametric LCS calculated on AST and ALP levels as 0.03343515 × ln (AST, U/L) + 0.02687997 × ln (ALP, U/L), and 0.232 was set as optimal cutoff value. Patients in low (LCS < 0.232) or high (LCS ≥ 0.232) score group experienced different survival times; median OS was 13.54 (95% CI: 11.1-15.6) months in the low LCS group and 7.3 (6.6-9.3) months in the high LCS group (p < 0.001). A nomogram including LCS and other clinical parameters was constructed and showed superior performance than model not including LCS. AUC of 6-month ROC improved from 0.647 (95% CI: 0.584-0.711) to 0.699 (0.638-0.759) in internal validation, and 0.837 (0.734-0.940) to 0.875 (0.784-0.966) in external validation. Liver chemistry score is useful in determining the prognosis of gastric cancer patients with liver metastasis and may be helpful to clinicians in decision-making.

Maternal and Perinatal Outcome in Pregnancy Complicated by Intrahepatic Cholestasis.

IntroductionIntrahepatic cholestasis of pregnancy (IHCP) is characterized by pruritus of the hand and sole with abnormal liver function test and bile acid metabolism. IHCP occurs in the second and third trimesters of pregnancy and usually resolves after delivery. The overall prevalence is about 1.2 to 1.5%. This study was conducted to assess the fetomaternal outcome according to maternal serum bile acids levels and its correlation with liver function tests in patients with IHCP.Material and methodsThis ambispective observational study was conducted in the department of Obstetrics and Gynecology (OBG) for two years at AIIMS Jodhpur, Rajasthan. It included all the pregnant women attending the outpatient department of OBG with the complaint of pruritis in the palm and sole after 28 weeks of pregnancy and diagnosed with intrahepatic cholestasis of pregnancy after investigations.ResultsOnly 152 patients were diagnosed with IHCP out of 4,148 deliveries, with a prevalence of 3.6%. Among these, 140 (92.11%) had mild IHCP, 10 (6.58%) had moderate IHCP and two (1.32%) had severe IHCP. There was a significant difference between the birth weight in mild, moderate and severe IHCP (P-value 0.004). About 12.5% (n=19) of patients had meconium-stained liquor during delivery. Two patients (1.32%) with moderate IHCP had intrauterine fetal death in the third trimester, and 6.58% (n=10) neonates were kept on continuous positive airway pressure.ConclusionsIHCP is associated with adverse fetal outcomes like spontaneous or iatrogenic preterm delivery, low birth weight, increase in the rate of lower section cesarean section (LSCS) and intrauterine death of a fetus. A significant correlation found between raised bile acid levels and variables of liver function test, hence cost-effectiveness and feasibility of liver function test (LFT) should be considered for the management of IHCP.

A cross-sectional study on the incidence of retinal changes and its correlation with variables like blood pressure, liver function tests, kidney function tests, proteinuria, and pedal edema in patients of pregnancy-induced hypertension in a rural setting.

Pregnancy-induced hypertension is a multisystem disorder that occurs after 20 weeks of pregnancy usually in primigravidas and is characterised by proteinuria, pedal edema, hypertension, and abnormal liver and kidney function tests. Since there exists a close relationship between retinal, cerebral, and renal vessels, fundoscopy gives the opportunity of observing the changes in the vascular tree. We conducted a study on 203 pregnant females over a period of 1.5 years in the rural population of North India. We recorded the baseline data from the patient files, including the biochemical investigations, and conducted a fundoscopic examination of all patients included in the study, and correlation of various variables was established. Out of 203 patients (403 eyes), 60% were primigravidas of mean age 25.71 ± 4.46 years with the mean duration of pregnancy being 36 weeks. The mean systolic and diastolic blood pressure were160 and 101 mmHg, respectively. There was no significant correlation was seen of proteinuria with eclampsia and the fundus findings. But there was a significant correlation between proteinuria and pedal edema and between the fundus findings and deranged LFT and KFT values. Relationship between the variables was calculated by using Chi-square and Fisher's exact test. A P value < 0.05 was taken as significant. Hypertension in pregnancy is the major concern of public health issue worldwide. With proper understanding of the correlating factors such as fundus changes which are directly correlated with whole bo dy vascular changes, which might affect the fetal growth, we can easily predict the outcome and can take appropriate actions as early as possible.

Methotrexate for chronic non-necrotizing anterior scleritis in Chinese patients.

To evaluate the effectiveness and corticosteroid-sparing capabilities of methotrexate (MTX) in the treatment of chronic non-necrotizing anterior scleritis in Chinese patients. A retrospective chart review of all patients with active anterior scleritis between January 2015 and June 2019 was conducted. All patients received 10 to 15 mg/wk MTX orally, and corticosteroids (10 to 40 mg/d prednisolone or equivalent methylprednisolone) with slow tapering. Topical corticosteroid eye drops (1% prednisolone actate, 0.1% dexmathosone or 0.1% fluoromethalone) were applied to control comorbid anterior uveitis at presentation or during follow up. The main outcomes were inflammation control and corticosteroid-sparing success, and secondary outcomes were reduction of immunosuppression load and best-corrected visual acuity (BCVA). Thirty-two eyes (22 patients) were included. The proportion of patients who achieved corticosteroid-sparing success was 50.0% at 3mo and 77.3% at 12mo [8 (36.4%) patients discontinued corticosteroid]. The proportion of eyes that achieved inflammation control was 59.4% at 3mo and 78.1% at 12mo. The immunosuppression load was 5.14±0.87 at presentation and 2.76±2.34 at 12mo (P<0.01). BCVA maintained unchanged or improved in 29 (90.6%) of all affected eyes. One patient discontinued MTX treatment because of an abnormal liver function test, and no other serious adverse effects were observed. According to this pilot study, low dose MTX appear to be a well-tolerated and effective treatment for chronic non-necrotizing anterior scleritis patients in the Chinese population.

COVID-19: Current Status in Gastrointestinal, Hepatic, and Pancreatic Diseases-A Concise Review.

The gastrointestinal tract plays an important role in the pathogenesis of COVID-19. The angiotensin-converting enzyme 2 receptor and the transmembrane protease serine 2 receptor bind and activate SARS-CoV-2 and are present in high concentrations throughout the gastrointestinal tract. Most patients present with gastrointestinal symptoms and/or abnormal liver function tests, both of which have been associated with adverse outcomes. The mechanisms of liver damage are currently under investigation, but the damage is usually transient and nonsevere. Liver transplantation is the only definitive treatment for acute liver failure and end-stage liver disease, and unfortunately, because of the need for ventilators during the COVID-19 pandemic, most liver transplant programs have been suspended. Patients with gastrointestinal autoimmune diseases require close follow-up and may need modification in immunosuppression. Acute pancreatitis is a rare manifestation of COVID-19, but it must be considered in patients with abdominal pain. The gastrointestinal tract, including the liver and the pancreas, has an intimate relationship with COVID-19 that is currently under active investigation.

Intrahepatic cholestasis of pregnancy: Green-top Guideline No. 43 June 2022.

Intrahepatic cholestasis of pregnancy: Green-top Guideline No. 43 June 2022.

Routine use of Fribrosis-4 index in lipid clinic

Background and Aims : Non-alcoholic fatty liver disease (NAFLD), the hepatic manifestation of metabolic syndrome, is a common cause of chronic liver disease and abnormal liver function test (LFT) in UK, yet it remains underdiagnosed. The number of patients presenting to lipid clinic with metabolic syndrome is increasing. Non-invasive biomarkers such as Fribrosis-4 (FIB-4) index is a helpful screening tool to exclude advanced fibrosis in high-risk patients. Therefore, we assessed the clinical utility of FIB-4 in a secondary care lipid clinic.

A study of abnormal liver function in pregnancy and its correlation with fetomaternal outcome in a teaching hospital of Kolkata in Eastern India

Background: Liver is a vital organ to maintain physiology of the body and supports every organ of the body. Its proper functioning during pregnancy is essential for a good maternal and fetal outcome. The study analyzes the causes and fetomaternal outcome in pregnancies and suggests measures to reduce morbidity and mortality. Aims and Objectives: This study aims to analyze the maternal and fetal outcome in pregnancy complicated with abnormal liver function test. Materials and Methods: This was hospital-based observational prospective study conducted at NRS Medical College and Hospital from March 2020 to August 2021. Total 144 pregnant women with abnormal liver function were included in the study. Template was generated and analysis was done on SPSS software. Results: Among 144 pregnant women 44.4% patients were 21–25 years of age. About 79.2% patients had &lt;2 serum bilirubin, 13.9% patients had 2–5 serum bilirubin, 2.8% patients had abruption, 11.8% patients had convulsion, and 9.3% patients had fetal bradycardia. About 13.9% patients had acute kidney injury, 22.2% patients had BT, 9.7% patients had hemolysis, elevated liver enzymes and low platelets, 15.3% patients had postpartum hemorrhage, and 3.8% patients had maternal death. In our study, 34.7% patients had pre-eclampsia and 11.8% patients had eclampsia. Conclusion: Abnormal liver function during pregnancy is associated with adverse events for both the mother and the fetus. Regular antenatal check-up, screening, and diagnosing liver disorder can save the lives of many mothers and fetus.

Laboratory Findings in Different Disease Status of COVID-19 Admitted Patients at Dilla University Referral Hospital Treatment Center, South Ethiopia.

BackgroundMillions were infected and many were dying because of the coronavirus disease 2019, since its emergence. The patients experience asymptomatic, mild, moderate, severe and critical disease with varying signs and symptoms. Decreased lymphocytes and abnormal liver and renal function tests are common among COVID-19 patients. Severe and critical cases show higher number of white blood cells, and neutrophils. However, studies showed different laboratory findings in different disease status. Therefore, this study investigated laboratory findings of COVID-19 admitted patients at Dilla University Referral Hospital treatment center, South Ethiopia.MethodsA retrospective study design was conducted on 220 patients confirmed by real time polymerase chain reaction, and admitted to Dilla University Referral Hospital treatment center from September 2020 to July 2021. Data were collected from the patients’ record, and analyzed by GraphPad Prism version 8.0.1.244 software. Descriptive statistics were used to analyze the frequency while independent t-test was used to compare means of each parameter for each disease status.ResultsOf the 220 study cases, 120 (54.5%) were severe, 89 (40.5%) were moderate and 11 (5.0%) were mild. One hundred forty (71.1%) of the 197 laboratory tested cases, 87 (77.7%) of severe, and 49 (64.5%) of the moderate cases had neutrophils above normal range. However, 134 (68.0%) of them, 82 (73.2%) of severe and 49 (64.5%) of moderate cases showed decreased lymphocyte level. Most of the cases showed an increased level of aspartate transaminase, alanine transaminase, alkaline phosphatase, total bilirubin, and total calcium. There was statistically significant mean neutrophils (p=0.04), number of white blood cells (p= 0.02), and creatinine level (p=0.00) difference between severe and mild cases.ConclusionMost of the severe COVID-19 patients showed increased neutrophils, liver function tests; and decreased lymphocytes; suggesting higher inflammation and lymphopenia. Therefore, patients with severe and critical disease status require close follow-up.

Hepatobiliary System Effects And Clinical Features of Sars-Cov-2 Infection; Case-Control Study

Introduction: Pandemic caused by SARS-CoV-2 infection has been an important health problem worldwide for the last 3 years. The pathogenesis and consequences of liver injury developed in COVID-19 disease are still unclear. We investigated the prevalence of liver function tests (LFTs) abnormalities in COVID-19 patients, their relationship with drugs, the difference between severe and non-severe COVID-19 patients, and the results of the course of LFTs among patients hospitalized in intensive care units and clinics. Methods: 389 patients who applied to Eskişehir City Hospital between March 2020 and October 2020 were included in the study. Demographic data of RT-PCR (+) patients and RT-PCR (-) control groups (age, gender, comorbidities, symptoms), laboratory parameters, radiological examinations, follow-ups in the clinics and intensive care units, drugs used for the infection were collected retrospectively. All patients with COVID-19 were classified as severe cases or mild to moderate cases groups. Results: Abnormal LFTs were found in 115 (35.2%) of 321 patients with RT-PCR(+), and in 10 (14.7%) of 68 patients in the PCR(-) control group. LFTs at the time of hospitalization were 10.3%, 22.7%, 4.9%, 11.4% and 1.2% in the patient group, respectively; in the control group, it was 1.9%, 2.9%, 2%, 3.3%, 0.8% (p=0.610, p=0.00, p=0.269, p=0.198, p=0.158). There was a significant increase in LFTs in patients who received antibiotics (Levofloxacin, Ceftriaxone, Clarithromycin, Tazobactam, Carbapenem), low molecular weight heparins and antiviral (favipravir) treatments (p=0.001, p=0.001, p=0.001). While the increase in LFTs were significant in the mild (40.2%; 8.2%) and severe groups (41.2%; 5.2%), the number of patients with elevated LFTs in the control group was low (0.5%). Conclusion: Liver damage is common in SARS-CoV-2 infection, but it is quite mild. Patients with severe COVID-19 have a higher frequency of abnormal LFTs than those with mild disease. Disease severity, pre-existing liver disease, and advanced age are risk factors for liver damage. Drug-induced liver injury, systemic inflammatory response syndrome, and hypoxia-induced liver injury may be the main etiological factors for liver injury in COVID-19.

The utility of liver function tests and abdominal ultrasound in infectious mononucleosis-A systematic review.

A large proportion of patients with infectious mononucleosis (IM) have abnormal liver function tests (LFT) at presentation. There is no guideline regarding the management and follow-up of these patients. Some patients also have abdominal ultrasound (US) due to deranged LFT, the need for this practice is unclear. The aim of this systematic review was to evaluate the evidence base on LFT assessment in IM, time to resolution of derangement, and the role of abdominal US. A systematic search of PubMed, EMBASE and the Cochrane library was done. Two authors independently screened records for eligibility using pre-defined criteria. We included both adult and paediatric populations. Quality assessment of included studies was done. A total of 3924 patients were included from 32 studies, of which LFT values were reported on 2779 patients. A combination of typical clinical features, heterophile antibodies and Epstein-Barr virus-specific antibodies were used to ascertain diagnosis. The following proportion of patients had abnormal LFT: aspartate transaminase (57%); alanine transaminase (62%); alkaline phosphatase (65%); bilirubin (16%); gamma-glutamyltransferase (41%). Reported median (interquartile range) time to resolution of LFT was 8 (6-12) weeks (n=438). Maximum time to resolution was >6months. Clinical hepatomegaly and splenomegaly were found in 35% and 44% of patients, respectively. Enlarged liver and spleen on US were seen in 16 of 29 and 38 of 38 of patients, respectively. There were no reports of decompensated liver disease. Current evidence questions the need for routine assessment of LFT in immunocompetent patients presenting with IM; serial LFT assessments following initial abnormalities are not required in immunocompetent patients with subclinical derangement of LFT; routine US abdomen in IM to evaluate for derangement of LFT is not required.

The Prevalence of Non-infectious Diseases Among Overseas Chinese Workers in 2018.

With the "Belt and Road" initiative, more Chinese citizens have gone abroad to engage in overseas labor activities. Few studies have investigated the prevalence of non-infectious diseases among Chinese overseas workers. This study seeks to fill the gap and illustrate the relevant diseases in a population of Chinese overseas workers. The health records of 13,529 Chinese migrant workers (12,917 males, mean age 41.3 ± 8.7 years, and 612 females, mean age 33.1 ± 10.2 years) who visited the International Travel Health Care Center in Anhui province were obtained. Chi-square test and binary logistic regression models were used to analyze the associations between the prevalence of non-infectious diseases and sex, as well as the association between non-infectious diseases and length of stay abroad. In this study, 34.6% of overseas workers were found to have one or more types of non-infectious diseases. Hypertension had the highest prevalence (9.58%). Hypertension, fatty liver, renal disease and abnormal liver function tests were more prevalent among male workers than among female workers, while anemia and abnormal urinalysis were more prevalent among female workers. The prevalence of hypertension, renal diseases, liver diseases and gallbladder diseases increased with the length of stay abroad. Non-infectious diseases including cardiovascular diseases, diabetes, and chronic respiratory diseases were highly prevalent among Chinese overseas workers. Hence the monitoring of non-infectious diseases needs to be enhanced to reduce China's overall disease burden in the future.

A Systematic Review of SARS-CoV-2-Associated Hepatic Dysfunction and the Impact on the Clinical Outcome of COVID-19.

Coronavirus disease 2019 (COVID-19) has rapidly spread across the globe since December 2019. The spectrum of clinical manifestations of COVID-19 ranges from mild to life-threatening forms. Alteration of hepatic function in COVID-19 is multifactorial. The objective of this systematic review is to assess the relationship between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-induced hepatic dysfunction and the clinical outcome in patients infected with COVID-19. We methodically explored several electronic databases (PubMed, PubMed Central, MEDLINE, and Google Scholar) in April 2022 using focused words and terms of medical subject headings for appropriate studies. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for conducting our systematic review. Hepatic dysfunction was identified as elevation of liver function tests (LFTs) above the upper limit of normal. The clinical outcome was described as a combination of mortality, intensive care unit (ICU) transfer, and the need for mechanical ventilation (MV). The initial search yielded a total of 7187 studies. After elimination of duplicates, exclusion of studies based on irrelevant titles and abstracts, comprehensive analysis of full-text formats, and evaluation of quality, a total of 16 studies were eligible to be included in our systematic review. In the 16 selected studies, there were 23,962 patients. The SARS-CoV-2 virus can negatively affect several organ systems by interacting with specific receptors widely expressed in the human body. A multifactorial etiology of hepatic dysfunction is observed in COVID-19. SARS-CoV-2 infection is associated with abnormal LFTs. Significantly higher mortality, ICU admissions, and requirement for MV are associated with LFT alterations. For this reason, patients infected with COVID-19 must have their hepatic function closely monitored.

Performance of the predictive criteria of the American Society for Gastrointestinal Endoscopy in the diagnosis of choledocholithiasis at a secondary care public hospital in the State of Nuevo León, Mexico

Introduction and aimsCurrently there is no ideal diagnostic/therapeutic approach for patients with suspected choledocholithiasis. The primary aim of our study was to evaluate the performance of the criteria for predicting choledocholithiasis proposed by the American Society for Gastrointestinal Endoscopy (ASGE) in 2019. Materials and methodsA retrospective study was conducted that included 352 patients seen at a secondary care public healthcare institution in Monterrey, Nuevo León, that treats an open population and does not have endoscopic ultrasound or magnetic resonance cholangiopancreatography at its disposal. ResultsThe most frequent predictor presented by the patients was abnormal liver function tests (90.63%), and with their use alone, sensitivity was higher than that of all the predictors analyzed (91.41%). In addition, the finding of common bile duct stones on ultrasound imaging was the only predictor independently associated with the confirmatory diagnosis of choledocholithiasis. Regarding the general performance of the 2019 criteria, the high-risk category had 68.75% sensitivity, 52.08% specificity, a positive predictive value of 79.28%, a negative predictive value of 38.46%, diagnostic accuracy of 64.20%, and a confirmatory diagnosis of choledocholithiasis in 79.28% of the patients of that risk category. ConclusionsThe study corroborated that the presence of choledocholithiasis could be predicted using the choledocholithiasis predictors and risk categories proposed by the ASGE, with acceptable accuracy, in accordance with the standards suggested by those same guidelines.