title: Predictor factors for choledocholithiasis.
abstract: BACKGROUND
  The choledocolithiasis has an incidence of 8-20% in patients with cholecystolithiasis. The preoperative diagnosis guides the interventional treatment on the bile duct
  
  
  OBJECTIVE
  To evaluate the sensitivity and specificity of the laboratory markers and imaging studies for choledocholithiasis preoperatively.
  
  
  METHODS
  The study comprised 254 patients divided into two groups: the control group (207 patients), patients without choledocholithiasis intraoperatively and cases group (47 patients), that enrolled the patients with choledocholithiasis intra-operatively. Were evaluated the laboratory markers, image exams and intra-operative diagnostic aspects.
  
  
  RESULTS
  The sample was homogeneous for age and gender. It was observed that 47% of the cases the patients did not show comorbidities. Hospitalization showes in cases group acute pancreatitis in12.8%, jaundice in 30%, fever in 30% and pain in the right hypochondrium in 95%. By comparing them, was observed that fever and jaundice were the signs and symptoms with statistical significance. Patients with choledocholithiasis had transaminases, alkaline phosphatase, gamma-glutamyl transferase and higher bilirubin with statistical significance (p<0.001). In regard to imaging studies, ultrasound was fairly accurate for cholelithiasis and choledocholithiasis (p<0.001).
  
  
  CONCLUSIONS
  Changes in canalicular and transaminase enzymes are suggestive for preoperative choledocholithiasis; GGT showed better sensitivity and alkaline phosphatase greater specificity; ultrasonography and nuclear magnetic resonance cholangiopancreatography showed high specificity.
authors.affiliation: Hospital Regional Dr. Homero de Miranda Gomes, São José, SC, Brazil.
authors.forename: Joana
authors.initials: J
authors.lastname: Tozatti
authors.affiliation: Hospital Regional Dr. Homero de Miranda Gomes, São José, SC, Brazil.
authors.forename: André Luiz Parizi
authors.initials: AL
authors.lastname: Mello
authors.affiliation: Hospital Regional Dr. Homero de Miranda Gomes, São José, SC, Brazil.
authors.forename: Orli
authors.initials: O
authors.lastname: Frazon
mesh_terms: D015415:Biomarkers / Q000097:blood; D042883:Choledocholithiasis / Q000097:blood / Q000175:diagnosis*; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers