Predictive models for stratifying patients suspected of having stones in the common bile duct
| Study | Predictive variables | Comments | |
|---|---|---|---|
| Hauer-Jensen et al.9 | Elevated bilirubin level; advanced; or evidence of stones in the common bile duct on ultrasound or computed tomography images | Negative predictive value 97%–100% | |
| Kama et al.10 | In patients < 71 years old: | Positive predictive value* | Negative predictive value* |
| • Common bile duct > 8 mm or evidence of stones in common bile duct on ultrasound | • 77% | • 98% | |
| • γ-Glutamyltransferase level > 50 U/L | • 27% | • 99% | |
| • Bilirubin level > 20 μmol/L | • 28% | • 99% | |
| Onken et al.11 | Maximum preoperative bilirubin level; maximum diameter of common bile duct; aspartate transaminase and alkaline phosphatase levels | A normogram was used for the probability of common bile duct stones based on these variables (range from < 5% to 50%) | |
| Graham et al.12 | Variable: | Predictability of stones in the common bile duct:† | |
| • Ultrasound evidence of stones in the common bile duct | • 100% | ||
| • Ultrasound evidence of dilated common bile duct | • 71% | ||
| • Elevated bilirubin level | • 40% | ||
| • Elevated amylase level | • 42% | ||
| • Elevated alkaline phosphatase level | • 38% | ||
| • Abnormal findings on biliary scintigraphy | • 50% | ||
| Sharma et al.13 | • Elevated alkaline phosphatase level | • Sensitivity 14%; positive predictive value 33% | |
| • Ultrasound evidence of common bile duct stones or dilated common bile duct, or both | • Sensitivity 71%; positive predictive value 100% | ||
| Huguier et al.14 | Common bile duct ≥ 12 mm; gallstones ≤ 10 mm; advanced age; chronic or acute cholecystitis; and prior history of biliary colic | Using scoring system, likelihood of stones in the common bile duct = 2% with a score < 3.5; 17% with a score of 3.5–5.9; and 81% with a score > 5.9 | |
| Barkun et al.15 | Age > 55 years; bilirubin level > 30 μmol/L; common bile duct ≥ 12 mm or evidence of stone on ultrasound; gallstones ≤ 10 mm | Probability of stones in the common bile duct was 94% when all four variables were present, and 8% when all were absent | |