Rendimiento de los criterios predictivos de la Sociedad Americana de Endoscopía Gastrointestinal en el diagnóstico de coledocolitiasis en un hospital público de segundo nivel del Estado de Nuevo León, México

Abstract

Introduction and aims

Currently 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 methods

A 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.

Results

The 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.

Conclusions

The 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.