TTP6.03 Predictive markers for common bile duct stones

Aim Our analysis aims at identifying potential markers for common bile duct (CBD) stones. Methods Data of random consecutive 120 patients who had MRCP to assess for CBD stones was collected. We used T-test for numerical variables and chi square test for categorical variables. Binary logistic regression was used for univariate and multivariate analysis. Results Initial LFTs had no significant correlation to CBD stones, when assess alone or combined. The stepwise regression analysis showed interaction of initial bilirubin and age to be statistically sensitive predictor for CBD stones (P=0.002). This suggests that combination of high bilirubin and older age may correlate to the likelihood of CBD stones. Pancreatitis, cholangitis or US findings on initial diagnosis did not show statistical correlation with CBD stones, even when combined with initial Bilirubin in multivariate analysis. Pre-MRCP bilirubin was significantly higher in positive CBD stones compared to negative group (P<0.0001); however, the lower value of pre-MRCP bilirubin in negative group was not statistically significant (P=0.057). Pre-MRCP ALT and ALP did not have notable correlation when assessed alone or jointly. This indicates bilirubin is the strongest positive predictor among other LFTs, yet not a negative predictor. Static-normal and normalised LFTs trends were statistically negative predictors (P=0.008, P=0.001). A static-high trend showed significant correlation with positive CBD stones (P=0.003). Conclusion Considering the limitations of our analysis, studying interaction of bilirubin and age and LFTs trends in high-quality research may provide valuable conclusions. We would suggest repeating LFTs prior to MRCP, which can limit unnecessary MRCP scans.