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Endoscopia

versão On-line ISSN 2444-6483versão impressa ISSN 0188-9893

Resumo

ORTIZ-RUVALCABA, Oscar I. et al. Análisis de concordancia entre el diagnóstico clínico y el diagnóstico postCPRE en mujeres con sospecha de patología obstructiva de la vía biliar. Endoscopia [online]. 2019, vol.31, suppl.2, pp.142-147.  Epub 14-Fev-2022. ISSN 2444-6483.  https://doi.org/10.24875/end.m19000073.

Introduction:

Endoscopic retrograde cholangiopancreatography (ERCP) is almost exclusively therapeutic or palliative. However, during ERCP also perform diagnostic maneuvers as cholangiography, brush cytology, biopsy and cholangioscopy.

Objective:

Perform a concordance analysis beetwen diagnosis of previous ERCP and diagnosis post-ERCP in female patients with suspected of biliary obstructive disease in a General Hospital at Ciudad Juárez (México).

Methods:

A cross sectional study was performed in female patients underwent to ERCP (biliary obstructive disease suspected). We analyzed age, weight, height, body mass index, diagnosis preERCP and postERCP, total and differential bilirubin, amylase, liver enzymes, and complications. We realized a concordance analysis by Cohen Kappa between diagnosis pre and postERCP.

Results:

We include 80 patients, the most frequent diagnosis preERCP was choledocolithiasis with a 77.5%, followed by biliary pancreatitis with 12.5%. The most frequent diagnosis postERCP was also cholelithiasis, but with a decrease up to 50%, followed by Oddi sphincter stenosis with 20% and normal biliary ducts with 20%. The concordance analysis was only 47.5% of diagnosis and Cohen Kappa index was 0.05 (weak concordance). The most frequent complication was postERCP pancreatitis, and no mortality was reported.

Discussion:

The concordance between diagnosis pre and postERCP was very weak. Probably because for a lack of correct patient analysis (by who request the ERCP). Other important data was the 25% of patients with biliary duct normal, because 25% of them suffered complications (mild). The ERCP is not a purely diagnostic procedure, and never substitute to other image studies.

Palavras-chave : Endoscopic retrograde cholangiopancreatography; Choledocolithiasis; Diagnostic techniques; Digestive system; Biliary ducts.

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