Triple non-invasive diagnostic test for exclusion of common bile ducts stones before laparoscopic cholecystectomy

Table 1 Frequency of clinical variables in 200 patients with gallstones n (%)

Variables	Total	Women	Men
Obstructive jaundice
Yes	16 (8)	8 (5.1)	8 (18.6)
No	183 (92)	148 (94.9)	35 (81.4)
Total	199 (100)	156 (100)	43 (100)
History of jaundice
Yes	5 (2.5)	3 (1.9)	2 (4.7)
No	192 (97.5)	151 (98.1)	41 (95.3)
Total	197 (100)	154 (100)	43 (100)
Cholangitis
Yes	5 (2.5)	5 (3.2)	0
No	192 (97.5)	149 (96.8)	43 (100)
Total	197 (100)	154 (100)	43 (100)
Acute Pancreatitis
Yes	1 (0.5)	0	1 (2.3)
No	196 (99.5)	154 (100)	42 (97.7)
Total	197 (100)	154 (100)	43 (100)
History of Pancreatitis
Yes	2(1)	1 (0.6)	1 (2.3)
No	195(99)	153 (99.4)	42 (97.7)
Total	197(100)	154 (100)	43 (100)

Table 2 Association between the number of positive clinical variables and CBDS n (%)

Patients	Negative history	1 positive findings	2 positive findings	Total
Men		6 (14)
Women	145 (92.4)	7 (4.5)	5 (3.2)	157 (100)
Total	179 (89.5)	13 (6.5)	8 (4)	200 (100)

Table 3 The results of ultrasound investigations in 200 patients with gallstones (per gender) n (%)

Patients	Men	Women	Total
CBDS	5 (11.9)	3 (1.9)	8 (4.1)
CBD obstruction	6 (14.3)	6 (3.9)	12 (6.1)
CBDS and obstruction	1 (2.4)	0 (0)	1 (0.5)
CBD diameter > 10 mm	1 (2.4)	2 (1.3)	3 (1.5)
Dilated intrahepatic	0 (0)	1 (0.6)	1 (0.5)
bile duct branches
Normal	30 (69)	145 (92.3)	175 (87.3)
Total	43 (100)	157 (100)	200 (100)

CBD: Common bile duct; CBDS: Common bile duct stones.

Table 4 Results of liver tests in patients with gallstones (per gender) n (%)

Gender	S-bilirubin ≥ 1.5 dL/L			Alkaline phosphatase ≥ 400 UL/L
	Yes	No	Total	Yes	No	Total
Men	13 (30.2)	30 (69.8)	43 (100)	14 (32.6)	29 (67.4)	43 (100)
Women	11 (7)	146 (93)	157 (100)	16 (10.2)	141 (89.8)	157 (100)
Total	24 (12)	176 (88)	200 (100)	30 (15)	170 (85)	200 (100)

Table 5 Diagnostic value of each of the triple tests, alone and in combination n (%)

Variables	Sensitivity	Specificity	NPV	PPV
1. Medical history	44	92.5	90.5	38.1
2. Ultrasound	64	97.1	95	76.2
3. Alkaline phosphatase ≥ 400 Ul/L	32	95	90	26.7
4. Serum bilirubin ≥ 1.5 dL/L	30.3	76.2	89.2	25
2 + 3 + 4	80	82.9	96.7	40
2 + 3 or 2 + 4	32	97.1	90.9	61.5
2 + 1+ 3 or 4	84	81.7	97.3	39.6

NPV: Negative predictive value; PPV: Positive predictive value.