Utilidad de la Gamma Glutamil Transpeptidasa como factor predictivo temprano de Coledocolitiasis. Hospital Vicente Corral Moscoso 2018

Abstract

Background. Gamma glutamyl transpeptidase (GGT) is a liver enzyme whose elevation is observed in 93% of obstructive biliary pathology, mainly in choledocholithiasis. Objective. To determine the diagnostic value of GGT as an early predictive factor of choledocholithiasis in patients treated at the Vicente Corral Moscoso Hospital during 2018. Methodology. A diagnostic test study was carried out in 290 clinical histories of patients diagnosed with choledocholithiasis treated at the Vicente Corral Moscoso Hospital during 2018. The value of GGT at admission was recorded and analyzed with ERCP results as a gold test. standard. Sensitivity, specificity, positive predictive value, negative predictive value were calculated, in addition Odds Ratio was obtained with its 95% CI to establish the predictive validity of this enzyme. Results The mean age was 58.3 years ± 17.5 (SD). The female gender predominated 60%, primary education 44.8% and rural origin 70%. There was a probable association between choledocholithiasis with GGT elevation (OR 2.47; 95% CI: 1.21–5.01; p = 0.011), abdominal pain (OR 2.81; 95% CI: 1.39–5,66 p = 0.004), and jaundice (OR 3.23; 95% CI: 1–10.9; p = 0.04). The GGT has a sensitivity of 88.3% and specificity 10.2%, PPV 82.8% and NPV 15.5%. The power to predict choledocholithiasis with a high GGT is low, with an area under the curve of 0.56. Conclusions There is a probable relationship between elevated GGT and choledocholithiasis; However, its discriminative power for the diagnosis of this pathology is low.