Prevalencia y factores asociados de la coledocolitiasis en pacientes de 20 a 60 años de edad del servicio de emergencia de cirugía. Hospital Vicente Corral Moscoso. Cuenca- Ecuador, 2020

Abstract

Background: Choledocholithiasis is an emergency in the presence of symptomatic cholelithiasis. For diagnosis, clinical, biochemical and biliary tract ultrasound parameters are considered in predictive models that guide the performance of Endoscopic Retrograde Cholangiopancreatography (ERCP) to help diagnosis and intervention. Objective: to identify the prevalence of choledocholithiasis and its associated factors in patients between 20 and 60 years of age in the emergency department of Vicente Corral Moscoso Hospital during the year 2020. Materials and methods: quantitative cross-sectional analytical design. Sample of 118 (N144) patients with symptomatic cholecystitis. Clinical, biochemical and ultrasound data were collected from the clinical history: age, sex, clinical and biochemical characteristics, history of cholecystectomy and stone extraction, overweight/obesity. The ASGE -2010 model and ERCP were used. Descriptive and bivariate analysis was performed with chi-square, prevalence ratio and 95%CI. Results: 27.1% (95%CI 26.4 to 27.9) of the patients in the study presented choledocholithiasis diagnosed by CPRE. Thirty-nine percent had obesity. Mean bilirubin, TGO, TGP and alkaline phosphatase tests were higher than normal values, 36% of cases had positive EUS. Choledocholithiasis had no statistical relationship (p>0.05) with: sex, age older than 55 years, history of cholecystectomy, history of common bile duct stone extraction, overweight/obesity, pancreatitis complication; there was relationship with cholangitis complication (p<0.05; PR: 5.9; 95%CI: 3.7-9.4). Conclusions: CPRE is important in the diagnosis of choledocholithiasis when following the ASGE-2010 model. More studies on the subject are needed.