Predictors of choledocholithiasis in patients sustaining acute biliary pancreatitis
To assess the role of alkaline phosphatase (AP), gamil-glutamyltransferase (gammaGT) and abdominal ultrasound (US) as predictors of choledocholithiasis in patients sustaining acute biliary pancreatitis. Data was prospectively collected during a period of 31 months. Forty patients were included, 30 w...
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| Veröffentlicht in: | Revista da Associação Médica Brasileira (1992) 2004-10, Vol.50 (4), p.391-395 |
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| container_title | Revista da Associação Médica Brasileira (1992) |
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| creator | Parreira, José Gustavo Rego, Ronaldo Elias Carnut Campos, Tercio de Moreno, Cristina Hachul Pacheco, Jr, Adhemar Monteiro Rasslan, Samir |
| description | To assess the role of alkaline phosphatase (AP), gamil-glutamyltransferase (gammaGT) and abdominal ultrasound (US) as predictors of choledocholithiasis in patients sustaining acute biliary pancreatitis.
Data was prospectively collected during a period of 31 months. Forty patients were included, 30 were female and the mean age was 49 +/- 16. All patients sustaining acute biliary pancreatitis were enrolled. Patients with clinical jaundice and severe pancreatitis were excluded. Serum content of AP and gGT as well as US were assessed at admission and 48 hours before cholecistectomy. All patients underwent intra-operative cholangiography (IOC) or pre-operative endoscopic retrograde cholangiography (ERCP), which was indicated based on the odds of choledocholithiasis. In order to identify the predictors of choledocholithiasis, variables were compared between patients sustaining or not such alteration in cholangiography. Student t, Fisher and chi square tests were used for statistical analysis, considering p |
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Data was prospectively collected during a period of 31 months. Forty patients were included, 30 were female and the mean age was 49 +/- 16. All patients sustaining acute biliary pancreatitis were enrolled. Patients with clinical jaundice and severe pancreatitis were excluded. Serum content of AP and gGT as well as US were assessed at admission and 48 hours before cholecistectomy. All patients underwent intra-operative cholangiography (IOC) or pre-operative endoscopic retrograde cholangiography (ERCP), which was indicated based on the odds of choledocholithiasis. In order to identify the predictors of choledocholithiasis, variables were compared between patients sustaining or not such alteration in cholangiography. Student t, Fisher and chi square tests were used for statistical analysis, considering p<0.05 as significant. Positive (PPV) and negative predictor values (NPV) were calculated for each variable.
Upon admission, 15 (37%) patients sustained biliary tract dilatation and 5 (12%) choledocholithiasis at the US. Forty eight hours before the operation, 34 (85%) patients had altered levels of gGT and 16 (40%) of AP. Pre-operative US showed biliary tract dilatation in nine patients and choledocholithiasis in three. ERCP was performed in 15 (37%) cases. Higher PPV (55%) was attributed to pre-operative US, which had also a NPV of 96%.
The best predictor of choledocholithiasis in patients sustaining mild acute pancreatitis was the biliary tract dilatation in pre-operative US.</description><identifier>ISSN: 0104-4230</identifier><identifier>PMID: 15666019</identifier><language>por</language><publisher>Brazil</publisher><subject>Acute Disease ; Adolescent ; Adult ; Aged ; Alkaline Phosphatase - blood ; Biomarkers - blood ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy ; Choledocholithiasis - diagnosis ; Choledocholithiasis - diagnostic imaging ; Choledocholithiasis - surgery ; Clinical Enzyme Tests - standards ; Epidemiologic Methods ; Female ; gamma-Glutamyltransferase - blood ; Humans ; Male ; Middle Aged ; Pancreatitis - complications ; Ultrasonography</subject><ispartof>Revista da Associação Médica Brasileira (1992), 2004-10, Vol.50 (4), p.391-395</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>778,782</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15666019$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Parreira, José Gustavo</creatorcontrib><creatorcontrib>Rego, Ronaldo Elias Carnut</creatorcontrib><creatorcontrib>Campos, Tercio de</creatorcontrib><creatorcontrib>Moreno, Cristina Hachul</creatorcontrib><creatorcontrib>Pacheco, Jr, Adhemar Monteiro</creatorcontrib><creatorcontrib>Rasslan, Samir</creatorcontrib><title>Predictors of choledocholithiasis in patients sustaining acute biliary pancreatitis</title><title>Revista da Associação Médica Brasileira (1992)</title><addtitle>Rev Assoc Med Bras (1992)</addtitle><description>To assess the role of alkaline phosphatase (AP), gamil-glutamyltransferase (gammaGT) and abdominal ultrasound (US) as predictors of choledocholithiasis in patients sustaining acute biliary pancreatitis.
Data was prospectively collected during a period of 31 months. Forty patients were included, 30 were female and the mean age was 49 +/- 16. All patients sustaining acute biliary pancreatitis were enrolled. Patients with clinical jaundice and severe pancreatitis were excluded. Serum content of AP and gGT as well as US were assessed at admission and 48 hours before cholecistectomy. All patients underwent intra-operative cholangiography (IOC) or pre-operative endoscopic retrograde cholangiography (ERCP), which was indicated based on the odds of choledocholithiasis. In order to identify the predictors of choledocholithiasis, variables were compared between patients sustaining or not such alteration in cholangiography. Student t, Fisher and chi square tests were used for statistical analysis, considering p<0.05 as significant. Positive (PPV) and negative predictor values (NPV) were calculated for each variable.
Upon admission, 15 (37%) patients sustained biliary tract dilatation and 5 (12%) choledocholithiasis at the US. Forty eight hours before the operation, 34 (85%) patients had altered levels of gGT and 16 (40%) of AP. Pre-operative US showed biliary tract dilatation in nine patients and choledocholithiasis in three. ERCP was performed in 15 (37%) cases. Higher PPV (55%) was attributed to pre-operative US, which had also a NPV of 96%.
The best predictor of choledocholithiasis in patients sustaining mild acute pancreatitis was the biliary tract dilatation in pre-operative US.</description><subject>Acute Disease</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Alkaline Phosphatase - blood</subject><subject>Biomarkers - blood</subject><subject>Cholangiopancreatography, Endoscopic Retrograde</subject><subject>Cholecystectomy</subject><subject>Choledocholithiasis - diagnosis</subject><subject>Choledocholithiasis - diagnostic imaging</subject><subject>Choledocholithiasis - surgery</subject><subject>Clinical Enzyme Tests - standards</subject><subject>Epidemiologic Methods</subject><subject>Female</subject><subject>gamma-Glutamyltransferase - blood</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Pancreatitis - complications</subject><subject>Ultrasonography</subject><issn>0104-4230</issn><fulltext>true</fulltext><rsrctype>magazinearticle</rsrctype><creationdate>2004</creationdate><recordtype>magazinearticle</recordtype><sourceid>EIF</sourceid><recordid>eNo1kMtOwzAURL0A0VL4BeQVu0h-xU6XqOIlVQKJ7iPHvqEX5YWvs-DvCaJdnc3RzGgu2FpIYQqjtFixa6IvIZTTW3nFVrK01gq5XbOP9wQRQx4T8bHl4Th2EMc_YD6iJySOA598RhgycZopexxw-OQ-zBl4gx369LMYQ0iwaBnphl22viO4PXHDDk-Ph91LsX97ft097IupNNvCO6Wc0DrqUJXGhNiaaKGR1isZKm0BKiiFrpSTMgDIUKqoWmedtAqMVnrD7v9jpzR-z0C57pECdJ0fYJyptkuBNcYt4t1JnJseYj0l7JfN9fkF_QtyaFja</recordid><startdate>200410</startdate><enddate>200410</enddate><creator>Parreira, José Gustavo</creator><creator>Rego, Ronaldo Elias Carnut</creator><creator>Campos, Tercio de</creator><creator>Moreno, Cristina Hachul</creator><creator>Pacheco, Jr, Adhemar Monteiro</creator><creator>Rasslan, Samir</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>200410</creationdate><title>Predictors of choledocholithiasis in patients sustaining acute biliary pancreatitis</title><author>Parreira, José Gustavo ; Rego, Ronaldo Elias Carnut ; Campos, Tercio de ; Moreno, Cristina Hachul ; Pacheco, Jr, Adhemar Monteiro ; Rasslan, Samir</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p549-a7227033d3c8544cdf4d6eb16a21c836ee8e50382711cee1c52d2f767162e4323</frbrgroupid><rsrctype>magazinearticle</rsrctype><prefilter>magazinearticle</prefilter><language>por</language><creationdate>2004</creationdate><topic>Acute Disease</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Alkaline Phosphatase - blood</topic><topic>Biomarkers - blood</topic><topic>Cholangiopancreatography, Endoscopic Retrograde</topic><topic>Cholecystectomy</topic><topic>Choledocholithiasis - diagnosis</topic><topic>Choledocholithiasis - diagnostic imaging</topic><topic>Choledocholithiasis - surgery</topic><topic>Clinical Enzyme Tests - standards</topic><topic>Epidemiologic Methods</topic><topic>Female</topic><topic>gamma-Glutamyltransferase - blood</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Pancreatitis - complications</topic><topic>Ultrasonography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Parreira, José Gustavo</creatorcontrib><creatorcontrib>Rego, Ronaldo Elias Carnut</creatorcontrib><creatorcontrib>Campos, Tercio de</creatorcontrib><creatorcontrib>Moreno, Cristina Hachul</creatorcontrib><creatorcontrib>Pacheco, Jr, Adhemar Monteiro</creatorcontrib><creatorcontrib>Rasslan, Samir</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Revista da Associação Médica Brasileira (1992)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Parreira, José Gustavo</au><au>Rego, Ronaldo Elias Carnut</au><au>Campos, Tercio de</au><au>Moreno, Cristina Hachul</au><au>Pacheco, Jr, Adhemar Monteiro</au><au>Rasslan, Samir</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Predictors of choledocholithiasis in patients sustaining acute biliary pancreatitis</atitle><jtitle>Revista da Associação Médica Brasileira (1992)</jtitle><addtitle>Rev Assoc Med Bras (1992)</addtitle><date>2004-10</date><risdate>2004</risdate><volume>50</volume><issue>4</issue><spage>391</spage><epage>395</epage><pages>391-395</pages><issn>0104-4230</issn><abstract>To assess the role of alkaline phosphatase (AP), gamil-glutamyltransferase (gammaGT) and abdominal ultrasound (US) as predictors of choledocholithiasis in patients sustaining acute biliary pancreatitis.
Data was prospectively collected during a period of 31 months. Forty patients were included, 30 were female and the mean age was 49 +/- 16. All patients sustaining acute biliary pancreatitis were enrolled. Patients with clinical jaundice and severe pancreatitis were excluded. Serum content of AP and gGT as well as US were assessed at admission and 48 hours before cholecistectomy. All patients underwent intra-operative cholangiography (IOC) or pre-operative endoscopic retrograde cholangiography (ERCP), which was indicated based on the odds of choledocholithiasis. In order to identify the predictors of choledocholithiasis, variables were compared between patients sustaining or not such alteration in cholangiography. Student t, Fisher and chi square tests were used for statistical analysis, considering p<0.05 as significant. Positive (PPV) and negative predictor values (NPV) were calculated for each variable.
Upon admission, 15 (37%) patients sustained biliary tract dilatation and 5 (12%) choledocholithiasis at the US. Forty eight hours before the operation, 34 (85%) patients had altered levels of gGT and 16 (40%) of AP. Pre-operative US showed biliary tract dilatation in nine patients and choledocholithiasis in three. ERCP was performed in 15 (37%) cases. Higher PPV (55%) was attributed to pre-operative US, which had also a NPV of 96%.
The best predictor of choledocholithiasis in patients sustaining mild acute pancreatitis was the biliary tract dilatation in pre-operative US.</abstract><cop>Brazil</cop><pmid>15666019</pmid><tpages>5</tpages></addata></record> |
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| subjects | Acute Disease Adolescent Adult Aged Alkaline Phosphatase - blood Biomarkers - blood Cholangiopancreatography, Endoscopic Retrograde Cholecystectomy Choledocholithiasis - diagnosis Choledocholithiasis - diagnostic imaging Choledocholithiasis - surgery Clinical Enzyme Tests - standards Epidemiologic Methods Female gamma-Glutamyltransferase - blood Humans Male Middle Aged Pancreatitis - complications Ultrasonography |
| title | Predictors of choledocholithiasis in patients sustaining acute biliary pancreatitis |
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