Background:

Choledocholithiasis is the most common cause of obstruction of the bile ducts in patients with cholelithiasis. Without jaundice or dilation of the bile duct, the diagnosis is extremely difficult to suspect; it is possible for them to be diagnosed during surgery or time after it. Cholangioresonance or endoscopic retrograde cholangiopancreatography are reserved for cases with a high index of suspicion of choledocholithiasis. They are not performed routinely.

Objective:

To know the risk factors for asymptomatic choledocholithiasis in patients undergoing laparoscopic cholecystectomy.

Material and methods:

A prospective, analytical, comparative study was performed in patients who underwent laparoscopic cholecystectomy without clinical or radiological evidence to suspect choledocholithiasis. Based on the transoperative cholangiography, they were divided into two groups: without choledocholithiasis and with choledocholithiasis; p < 0.05 was considered statistically significant.

Results:

53 women (77.9%) and 15 men (22.1%). Alkaline phosphatase (AP) was the only parameter with significant difference between the groups (p = 0.034). With AP > 90.5 U/l, there was a 12.4-fold greater risk of presenting asymptomatic choledocholithiasis, with sensitivity and specificity of 80%.

Conclusions:

Asymptomatic choledocholithiasis in the General Hospital of Mexico is 13.2%. When a patient with cholelithiasis, without jaundice and without ultrasonographic dilation of the bile duct has AP > 90.5, we should suspect the presence of asymptomatic choledocholithiasis.