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[Performance of ASGE predictive criteria in diagnosis of choledocholithiasis in the Edgardo Rebagliati Martins Hospital]. / Rendimiento de los criterios predictivos de la ASGE en el diagnóstico de coledocolitiasis en el Hospital EdgardoRebagliati Martins.
Benites Goñi, Harold Eduardo; Palacios Salas, Fernando Vicente; Asencios Cusihuallpa, Jairo Luis; Aguilar Morocco, Rossmery; Segovia Valle, Nasthya Solange.
Afiliação
  • Benites Goñi HE; Servicio de Gastroenterología, Hospital Nacional Edgardo Rebagliati Martins. Lima, Perú.
  • Palacios Salas FV; Departamento de Aparato Digestivo, Hospital Nacional Edgardo Rebagliati Martins. Lima, Perú.
  • Asencios Cusihuallpa JL; Servicio de Gastroenterología, Hospital Nacional Edgardo Rebagliati Martins. Lima, Perú.
  • Aguilar Morocco R; Servicio de Radiología del Hospital Nacional Edgardo Rebagliati Martins. Lima, Perú.
  • Segovia Valle NS; Facultad de Medicina, Universidad Nacional Mayor de San Marcos. Lima, Perú.
Rev Gastroenterol Peru ; 37(2): 111-119, 2017.
Article em Es | MEDLINE | ID: mdl-28731990
BACKGROUND: In Peru, there are still no local studies designed for evaluating the performance of clinical guidelines designed to stratify patients according to probability of choledocholithiasis. OBJECTIVES: To evaluate the performance of predictive criteria proposed by the American Society for Gastrointestinal Endoscopy (ASGE) in diagnosis of choledocholithiasis. MATERIALS AND METHODS: A retrospective cohort study conducted in a hospital in Lima (Rebagliati hospital). Were included all patients with suspected choledocholithiasis who underwent endoscopic retrograde cholangiopancreatography (ERCP) between July 2014 and June 2015. Predictors of choledocholithiasis proposed by the ASGE and the diagnostic performance of the risk categories were evaluated. RESULTS: 118 patients met the inclusion criteria. In multivariate analysis, only age >55 years (OR: 3.07 [95: 1.14-8.31], p = 0.027) and the finding of stones in the common bile duct by abdominal ultrasound (OR: 1.68 [95% CI: 1.09-2.59], p = 0.018) were associated with the presence of choledocholithiasis on ERCP. The performance of the high and intermediate risk categories were 75.82% and 70.37% respectively. The performance of the high-risk category improved to 85.90% using a second set of biochemical markers. CONCLUSIONS: The performance of the predictors and risk categories proposed by the ASGE in diagnosis of choledocholithiasis is acceptable in our hospital, according to the proposed standards; however, it must be further improved to prevent the use of diagnostic ERCP.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Indicadores Básicos de Saúde / Técnicas de Apoio para a Decisão / Coledocolitíase Tipo de estudo: Diagnostic_studies / Etiology_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude / Patient_preference Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Peru Idioma: Es Revista: Rev Gastroenterol Peru Assunto da revista: GASTROENTEROLOGIA Ano de publicação: 2017 Tipo de documento: Article País de publicação: Peru
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Indicadores Básicos de Saúde / Técnicas de Apoio para a Decisão / Coledocolitíase Tipo de estudo: Diagnostic_studies / Etiology_studies / Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude / Patient_preference Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Peru Idioma: Es Revista: Rev Gastroenterol Peru Assunto da revista: GASTROENTEROLOGIA Ano de publicação: 2017 Tipo de documento: Article País de publicação: Peru