Preoperative risk of common bile duct stones in cholecystectomies at a tertiary hospital in João Pessoa-PB

Abstract

Introduction: gallstones are one of the most common diseases of the digestive tract, affecting 6-10% of the adult population. Of these, approximately 8-20% have associated choledocholithiasis. Preoperative risk stratification of choledocholithiasis in patients with cholelithiasis seeks to allow setting of a proper therapy, in a timely manner, for each case. Objective: stratify preoperative risk of choledocholithiasis in patients undergoing cholecystectomy in a tertiary hospital. Methods: descriptive, retrospective observational study, based on the analysis of medical records of patients undergoing cholecystectomy for gallstones in a public hospital in João Pessoa, Paraíba, between August 2021 and January 2022. Risk stratification was performed based on American Society for Digestive Endoscopy (ASGE) criteria from 2010. Results: 41 patients were evaluated. Most of them were female, with a mean age of 49.6 years, most of whom underwent laparoscopic cholecystectomy without intraoperative cholangiography. The most common imaging performed preoperatively was abdominal ultrasound. According to ASGE criteria, 18 (43.9%) patients were classified as low risk, 19 (46.4%) were stratified into intermediate risk, and 4 scored high risk (9.7%). Conclusion: despite a limited sample size, there is a relevant prevalence of high or intermediate preoperative risk of choledocholithiasis in patients with cholelithiasis. Risk stratification for choledocholithiasis is an important tool to be routinely used in the preoperative period of cholecystectomy in patients with diagnosis of cholelithiasis.

Keywords: gallstones, cholelithiasis, choledocholithiasis.