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ISSN 2594-1518 (Electronic)
ISSN 1405-0099 (Print)

2018, Number 3

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Cir Gen 2018; 40 (3)

Risk factors for asymptomatic choledocholithiasis; experience at the Hospital General de México

González-Pérez LG, Zaldívar-Ramírez FR, Tapia-Contla BR, Díaz-Contreras-Piedras CM, Arellano-López PR, Hurtado-López LM

Language: Spanish
References: 20
Page: 164-168
PDF size: 176.16 Kb.


ABSTRACT

Introduction: Choledocholithiasis is the most common cause of obstruction of the bile ducts in patients with cholelithiasis. Without jaundice or biliary tract dilation, the diagnosis is very difficult to suspect, and patients may be diagnosed during surgery or at some point after the procedure. Magnetic resonance cholangiopancreatography or endoscopic retrograde cholangiopancreatography are reserved for cases in which choledocholithiasis is highly suspected; they are not routinely performed. Objectives: To determine the risk factors for asymptomatic choledocholithiasis in patients who underwent laparoscopic cholecystectomy. Materials and methods: A prospective, analytic, comparative study was conducted in patients undergoing laparoscopic cholecystectomy without clinical or radiological evidence suggesting choledocholithiasis. Based on intraoperative cholangiography, they were divided into two groups: with choledocholithiasis and without choledocholithiasis. A p value ‹significant. Results: 53 women (77.9%) and 15 men (22.1%). Alkaline phosphatase (AP) was the only parameter significantly different between the groups (p = 0.034). An AP value › 90.5 U/L indicated a 12.4 higher risk for asymptomatic choledocholithiasis, with an 80% sensitivity and specificity. Conclusions: Prevalence of asymptomatic choledocholithiasis at the Hospital General de México is 13.2%. When a patient has cholelithiasis, with no jaundice or biliary tract dilation but an AP value above › 90.5 U/L, asymptomatic choledocholithiasis should be suspected.


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