Preoperative diagnosis of common bile duct stones : possibilities and opportunities

Abstract

Choledocholithiasis occurs in 5-20 % of patients with cholelithiasis; however, the optimal algorithm for its preoperative detection has not yet been developed. A retrospective study of 546 patients with cholelithiasis was carried out to research the diagnostic capabilities of the algorithm for choledocholithiasis risk stratification proposed by the ASGE and to determine the predictors of choledocholithiasis. The accuracy of the diagnostic algorithm was 78 %, the sensitivity was 91.7 %, and the specificity was 75.8 %. Indicators of total bilirubin in the blood 35 umol/L and the presence of a stone in the common bile duct during transabdominal ultrasound had sufficient predictive accuracy to determine the subsequent tactics of managing patients.