Sarli et al developed a score for predicting the risk of a common bile duct (CBD) stone. The authors are from Parma University in Parma, Italy.
|
Diameter of Gallstone |
Type |
|
< 3 mm |
micro |
|
3 - 5 mm |
small |
|
6 - 10 mm |
medium |
|
> 10 mm |
large |
Parameter:
(1) ultrasound findings
(2) biliary colic
(3) increase in serum AST (SGOT) and/or alkaline phosphatase
(4) type of gallstones
(5) dyspepsia
(6) cholecystitis
|
Parameter |
Finding |
Points |
|
ultrasound findings |
negative |
0 |
|
|
positive (see below) |
4 |
|
biliary colic |
absent |
0 |
|
|
present |
1 |
|
increase in serum enzymes |
no |
0 |
|
|
yes |
1 |
|
type of gallstones |
non-dangerous |
0 |
|
|
dangerous |
1 |
|
dyspepsia |
absent |
0 |
|
|
present |
-2 |
|
cholecystitis |
absent |
0 |
|
|
present |
-3 |
where:
• Positive ultrasound findings: dilatation of common bile duct > 7 mm and/or presence of common bile duct stones.
• Dangerous gallstones: multiple micro or small gallstones.
• Nondangerous gallstones: single OR medium to large size
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: -5
• maximum score: 7
• The higher the score the greater the risk of common bile duct stones.
• In theory a person with a common bile duct stone seen on ultrasound could be placed in the low risk group. For the implementation the presence of stone in the common bile duct will automatically be called high risk.
|
Total Score |
Risk of CBD Stones |
|
-5 to 1 |
low |
|
2 |
moderate |
|
3 to 7 |
high |
Specialty: Gastroenterology, Surgery, general
ICD-10: ,
