Lledo et al reported a score for preoperative prediction of choledocholithiasis. The authors are from Hospital Universitari i Politecnic La Fe, Valencia, in Spain.
Patient selection: possible choledocholithasis
Parameters:
(1) history of biliary disease (biliary colic, acute cholecystitis, acute biliary pancreatitis, choledocholithiasis)
(2) serum total bilirubin in mg/dL
(3) diameter of common bile duct on ultrasonography in mm
(4) serum alkaline phosphatase in IU/L
(5) serum GGT in IU/L
Parameter
Finding
Points
history
no
0
yes
1
serum total bilirubin
< 2 mg/dL
0
2 to 4 mg/dL
1
> 4 mg/dL
2
diameter of common bile duct
<= 8 mm
0
> 8 mm
2
serum alkaline phosphatase
< 150 IU/L
0
>= 150 IU/L
1
serum GGT
< 100 IU/L
0
>= 100 IU/L
1
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 7
Total Score
Choledocholithiasis
0 to 2
no
3 to 5
possible
>= 6
yes
Performance:
• A score >= 6 has a specificity of 100%
• A score < 3 had a negative predictive value of 100%
• The maximum Youden index is for a score >= 4.
To read more or access our algorithms and calculators, please log in or register.
