Description

Barkun et al identified factors associated with the presence of a common bile duct stone in a patient undergoing a laparoscopic cholecystectomy. The authors are from McGill University in Montreal.


 

Parameters for a patient with no stone seen in the duct on ultrasonography:

(1) age of the patient in years

(2) serum bilirubin in µmol/L

(3) dilatation of the common bile duct seen on ultrasonography (> 6 mm in diameter)

 

Age in Years

Serum Bilirubin

Dilated Common Bile Duct

Probability of Stone Seen ERCP

<= 55

<= 30 µmol/L

no

19%

<= 55

<= 30 µmol/L

yes

38%

<= 55

> 30 µmol/L

no

28%

<= 55

> 30 µmol/L

yes

49%

> 55

<= 30 µmol/L

no

38%

> 55

<= 30 µmol/L

yes

61%

> 55

> 30 µmol/L

no

50%

> 55

> 30 µmol/L

yes

72%

 

The presence of common bile duct stone seen on ultrasonography had a specificity of 90% (not 100%) in Table 2. This may be explained if the category is "suspected or detected" as given on page 35. According to the footnote to Figure 3, the range of probabilities for the above factors ranges from 58% to 94%.

 


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