OBJECTIVES: To evaluate the performance of predictive criteria proposed by the American Society for Gastrointestinal Endoscopy (ASGE) in diagnosis of choledocholithiasis

METHODS

: We searched MEDLINE and Cochrane Central to december 2017. We did not restrict studies based on language or publication status, or whether data were collected prospectively or retrospectively. We included studies that provided the sensibility and specificity ASGE scale for choledocholithiasis diagnoses only accepted studies that confirmed the presence of common bile duct stones by extraction of the stones for a positive test, and absence of common bile duct stones by surgical or endoscopic negative exploration of the common bile duct. At least two authors screened abstracts and selected studies for inclusion independently and quality was evaluated applying QUADAS -2 tool, we used

RESULTS

: We identified three studies including 3004 patients that reported the diagnostic accuracy of ASGE scale. Most studies included people with symptoms (participants with jaundice or pancreatitis) suspected of having common bile duct stones based on blood tests, ultrasound, or both, prior to the performance of ERCP or bile surgery. Most studies included participants who had not previously undergone removal of the gallbladder (cholecystectomy). None of the included studies was of high methodological quality as evaluated by the QUADAS-2 tool (quality assessment tool for diagnostic accuracy studies). The sensitivities of ASGE scale highed risk ranged between 0.56 and 0.80 and the specificities ranged between 0.44 and 0.70. There was weak evidence of a difference in sensitivity(P value = 0.05) showing higher sensitivity than clinical parameters

CONCLUSIONS

: High rish ASGE scale had a good sensibility but moderate specificity for diagnoses of choledoholithiasis.