Implementation of a Newly Devised Scoring System to Detect Retained Common Bile Duct Stones in Gallstone Pancreatitis

Arun Patil; Jasmine Agarwal; Shekhar Jadhav; Gagandeep Talwar

Volume : VIII, Issue : II, February - 2018

Implementation of a Newly Devised Scoring System to Detect Retained Common Bile Duct Stones in Gallstone Pancreatitis

Arun Patil, Jasmine Agarwal, Shekhar Jadhav, Gagandeep Talwar

Abstract :

Gallstones pancreatitis is caused by gallstones, which migrate to and block the common bile duct (CBD). To detect retained CBD stones, a scoring system was devised with the parameters (with 1 point for each): CBD size >/= 9 mm, Gamma glutamyl transferase (GGT) >/= 350 U/L, Alkaline phosphatase (ALP) >/= 250 U/L, Total bilirubin (TB) >/= 3 mg/ dL and Direct bilirubin (DB) >/= 2 mg/dL. A prospective observational study was carried out at a large tertiary care urban healthcare center over a period of 2 years comprising of 43 patients. Using our scoring system, we propose the following for patients: those with 0 or 1 points undergo LC with follow up; 2 points undergo LC or MRCP, based on the values of AST/ ALT; 3 or 4 points undergo MRCP; and 5 points should go directly to ERCP.