Validación de los predictores para coledocolitiasis de la Sociedad Americana de Endoscopia Gastrointestinal en pacientes de 20 a 60 años en el servicio de emergencia del Hospital Vicente Corral Moscoso Cuenca enero 2019 - abril 2021

Abstract

Background: Choledocholithiasis represents a prevalent complication of gallstones. The American Society for Gastrointestinal Endoscopy (ASGE) established a predictive criterion to confirm suspicion of choledocholithiasis. Objective: To determine the validity of the predictors of the American Society of Gastrointestinal Endoscopy for choledocholithiasis in patients aged 20–60 years in the emergency service of the Vicente Corral Moscoso Hospital in Cuenca, during January 2019 and April 2021. Methodological design: Applied research for the validation of ASGE predictors for choledocholithiasis, against ERCP as a Gold Standard test. Sample of 286 patients with probability of choledocholithiasis, calculated from a sensitivity of 80%, a minimum power of 80% and a specificity of 80%. The categorical variables were analyzed using frequencies and percentages; quantitative variables show the mean and standard deviation. Hypotheses were tested according to significance of p <0.05 and 95% confidence interval. Results: 35.3% are 20–30 years old, with a mean of 37.0 ± 11.4 years; 68.2% are women; 47.2% are overweight; 32.2% had a history; Acute cholecystitis is the most prevalent entry diagnosis (61.2%) and exit diagnosis (61.5%). 67.5% with bilirubin <1.8; 24.8% with bile duct dilation> 6mm; 52.4% with altered liver profile. Positive ERCP in 30.8%; 92.3% with laparoscopic cholecystectomy; 19.2% had very strong ASGE predictors. Sensitivity was 69.32%, specificity 91.43%, PPV 98.98%, NPV 19.91%, Youden index 71.02%. Conclusions: The ASGE criteria for choledocholithiasis are valid for the emergency service population of the Vicente Corral Moscoso Hospital in Cuenca.