AIM: To analyze retrospectively the records of 294 conse-cutive patients
operated upon for gallbladder stones, to determine the predictive
factors of synchronous common bile duct (CBD) stones and validate
prospectively the generated model.
METHODS: The prognostic estimation of a biochemical test and
ultrasonography alone to differentiate between the absence and presence
of choledocholithiasis was assessed using receiver operating
characteristics curve analysis. Multivariate analysis was employed using
discriminant analysis for establishment of a best model. Prospective
validation of the model was made.
RESULTS: Discriminant forward stepwise analysis disclosed that high
values (>= 2 x normal) of SGOT, ALP, conjugated bilirubin and CBD
diameter on ultrasound >= 10 mm were all prognostic factors of CBD
lithiasis in univariate and multivariate analysis, P<0.01. History was
not included in the model. Prospective validation of the model was
performed by multivariate analysis using Visual General Stepwise
Regression. Positive predictive value, when considering all these
predictors, was 93.3%, while the negative predictive value was 88.8%.
Sensitivity of the model was 96.5% and specificity 80%.
CONCLUSION: The above model can be objectively applied to predict the
presence of CBD stones. (C) 2005 The WJG Press and Elsevier Inc. All
rights reserved