Clinical discrimination between choledocholithiasis and biliopancreatic malignancy based on a new biochemical model.

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Clinical discrimination between choledocholithiasis and biliopancreatic malignancy based on a new biochemical model. (EN)

Kasapidis, P.
Konstantinidis, A.
Giannakopoulos, A.
Balatsos, V.
Delis, V.
Mironidis, L.
Skandalis, N.

Purpose: This study aims to establish predictive laboratory tests, which could confidently assist for an initial clinical discrimination of choledocholithiasis from biliopancreatic malignancy, before an invasive endoscopic or surgical diagnosis. Results: A total of 174 patients, who underwent ERCP were analyzed. Patients with final diagnosis of choledocholithiasis (137 patients) and biliopancreatic adenocarcinoma (37 patients) had their biochemistry parameters compared using Mann-Whittney test. Cut-off values for each parameter were defined. The cut-off values that provided the best trade-off between sensitivity and specificity were: 8.65 mg/ dL for total bilirubin, 276 U/L for serum alkaline phosphatase and 306 IU/ml for CA19-9. A patient most probably (96%) suffers from cancer, if he has high incriminating values in all these three parameters. Conclusions: A simple, reproducible, easy-to-obtain predictive model with laboratory tests, successfully differentiates choledocholithiasis from malignant biliopancreatic diseases and could be useful for a more cost-effective investigation and treatment of patients with such pathology. (EN)

Ελληνική Γαστροεντερολογική Εταιρία (EL)
Hellenic Gastroenterologiki Company (EN)

2008-11-10


Annals of Gastroenterology (EN)

Annals of Gastroenterology; Volume 21, No 2 (2008); 119-126 (EN)



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