The use of serum alkaline phosphatase as a choledocholithiasis marker to mitigate the cost of magnetic resonance cholangiography
Einstein (Säo Paulo)
; 21: eAO0204, 2023. tab, graf
Article
em En
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LILACS-Express
| LILACS
| ID: biblio-1448195
Biblioteca responsável:
BR1.1
ABSTRACT
ABSTRACT Objective To assess the predictive value of preoperative serum laboratory test results for identifying choledocholithiasis and reduce the use of cholangioresonance and its inherent costs. Methods Patients aged 21-69 years who underwent preoperative cholangioresonance examination at our institute were included. Patients with a history of fluctuating jaundice or biliary pancreatitis, bile duct dilatation on ultrasonography, and elevated levels of canalicular enzymes (alkaline phosphatase >100U/L and gamma-glutamyl transferase >50U/L) underwent cholangioresonance-guided surgery. Cases of choledocholithiasis confirmed by cholangioresonance were compared with those without choledocholithiasis. Serum laboratory data were evaluated and the diagnostic capabilities of these examinations were analyzed. Results A total of 104 patients were included. For detecting choledocholithiasis using alkaline phosphatase, the cut-off point was 78U/L, sensitivity was 97.6% (95%CI 87.4-99.9), and specificity was 72.6% (95%CI 59.8-83.1). In the binary logistic regression analysis, age (OR= 0.92; 95%CI 0.86-0.98) and alkaline phosphatase level (OR= 1.02; 95%CI 1.01-1.05) were selected for the final model. Conclusion Serum alkaline phosphatase levels may aid preoperative diagnosis of asymptomatic choledocholithiasis. After a global clinical assessment of the patient, serum laboratory findings may contribute to a reduction in cholangioresonance-related heathcare costs.
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Índice:
LILACS
Tipo de estudo:
Health_economic_evaluation
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Prognostic_studies
Idioma:
En
Revista:
Einstein (Säo Paulo)
Assunto da revista:
MEDICINA
Ano de publicação:
2023
Tipo de documento:
Article