ISSN 2063-5346
For urgent queries please contact : +918130348310


Main Article Content

Dr. Shalinder Koul , Dr. Heenu Dhar , Dr. A. K. Khurana , Dr. Vivek Goel
» doi: 10.31838/ecb/2023.12.si6.155


Risk scoring system based on the derangement in clinical, biochemical and radiological parameters helps significantly in predicting the chances of synchronous CBD stones which are not detected by ultrasonography alone, thus avoiding postoperative complications due to missed CBD stones. Materials and Methods: This prospective study was conducted in the Department of Surgery, Jaipur Golden Hospital, New Delhi, India from October 2007 to October 2009. All patients of upper abdominal pain admitted as routine or emergency cases underwent ultrasound study of the abdomen to rule out gallstone disease. In a known case of gallstone disease, suspicion of CBD stone was based on (A) history and clinical features, (B) biochemical tests and (C) ultrasonographic findings. Those patients of gallstone disease with absent risk factors (i.e. clinical, biochemical or radiologic) and those with obvious CBD stones on the ultrasound were excluded from the study. Results: 1. History of jaundice, raised serum levels of liver function tests (Serum bilirubin >1.5mg% and AST, ALT and Serum Alkaline phosphatase greater than upper limits of normal in combination) or individually Serum bilirubin >1.5mg%, ALT greater than three times the upper limit of normal, Serum Alkaline phosphatase greater than three times the upper limit of normal and CBD size >7mm on ultrasound are the statistically significant predictors of CBD stones in patients of gallstone disease admitted for cholecystectomy. Conclusions; Patients with Risk score 1 and 2 should be subjected to MRCP to confirm CBD stones before cholecystectomy as it is noninvasive. Risk score 3 patients should be subjected to ERCP before cholecystectomy due to higher chances of CBD stones in these patients and to get the best out of the endoscopic management of CBD stones.

Article Details