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Are liver function tests, pancreatitis and cholecystitis predictors of common bile duct stones?: Results of a prospective, population-based, cohort study of 1171 patients undergoing cholecystectomy
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Clinical Research, County of Västmanland.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Upper Abdominal Surgery.
2011 (English)In: HPB, ISSN 1365-182X, E-ISSN 1477-2574, Vol. 13, no 8, 519-527 p.Article in journal (Refereed) Published
Abstract [en]

Objective: The purpose of this study was to explore the accuracy of elevated liver function values, age, gender, pancreatitis and cholecystitis as predictors of common bile duct stones (CBDS). Methods: All patients operated on for gallstone disease over a period of 3 years in a Swedish county of 302 564 citizens were registered prospectively. Intraoperative cholangiography (IOC) was used to detect CBDS. Results: A total of 1171 patients were registered; 95% of these patients underwent IOC. Common bile duct stones were found in 42% of patients with elevated liver function values, 20% of patients with a history of pancreatitis and 9% of patients with cholecystitis. The presence of CBDS was significantly predicted by elevated liver function values, but not by age, gender, history of acute pancreatitis or cholecystitis. A total of 93% of patients with normal liver function tests had a normal IOC. The best agreement between elevated liver function values and CBDS was seen in patients undergoing elective surgery without a history of acute pancreatitis or cholecystitis. Conclusions: Although alkaline phosphatase (ALP) and bilirubin levels represented the most reliable predictors of CBDS, false positive and false negative values were common, especially in patients with a history of cholecystitis or pancreatitis, which indicates that other mechanisms were responsible for elevated liver function values in these patients.

Place, publisher, year, edition, pages
2011. Vol. 13, no 8, 519-527 p.
Keyword [en]
prediction, common bile duct stones, alkaline phosphatase (ALP), bilirubin, gallstone disease, cholecystectomy, dynamic intraoperative cholangiography, prospective population-based study, pancreatitis, cholecystitis
National Category
Surgery
Identifiers
URN: urn:nbn:se:uu:diva-156609DOI: 10.1111/j.1477-2574.2011.00317.xISI: 000292862600001OAI: oai:DiVA.org:uu-156609DiVA: diva2:432806
Available from: 2011-08-07 Created: 2011-08-04 Last updated: 2017-12-08Bibliographically approved

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