Feasibility Analysis Of Using VUHI For Choledocholithiasis Screening Before Cholecystectomy In Chinese Patients

Background: The Vilnius University Hospital Index(VUHI)was established in 1999 by Vilnius University Hospital and has been used for assessing the risk of choledocholithiasis from then until the current day.The aim of this study was to examine the clinical value of VUHI in the preoperative screening of choledocholithiasis in Chinese patients with cholecystolithiasis and to analyse and compare the value of VUHI with B-ultrasound,bilirubin concentration,glutamate transferase,aspartate transferase,alkaline phosphatase and gamma-glutamyl transferase.Objective: This study included 561 patients who underwent elective Laparoscopic cholecystectomy(LC)for cholecystolithiasis between June 2016 and June 2018.Methods: Receiver–operator curve(ROC)analysis was used to define the ideal cutoff values for clinicolaboratory characteristics and VUHI in Chinese patients.Univariate and multivariate analyses using preoperative clinicolaboratory characteristics and VUHI were performed to investigate the most significant risk factors for cholecystolithiasis associated with choledocholithiasis and to explore the feasibility of applying VUHI for choledocholithiasis screening prior to cholecystectomy.Results: Multivariate analysis using nine parameters selected by univariate analyses demonstrated that VUHI(?3.49)(odds ratio,39.57;95% confidence interval,22.64-69.14;P<0.001),?-glutamyltransferase(>80.65 ?mol/l)(odds ratio,21.17;95% confidence interval,12.52-35.78;P<0.001),alanine aminotransferase(>45.85 ?mol/l)(odds ratio,20.34;95% confidence interval,12.33-33.57;P<0.001),common bile duct diameter(>6 mm)(odds ratio,20.20;95% confidence interval,12.39-32.94;P<0.001),and aspartate aminotransferase(>36.45 ?mol/l)(odds ratio,17.58;95% confidence interval 10.72-28.84;P<0.001)were linked with cholecystolithiasis associated with choledocholithiasis.Among these five parameters,ROC curve analysis revealed that VUHI?3.49(0.907)has the largest area under the ROC for cholecystolithiasis associated with choledocholithiasis.Conclusion: VUHI can be used for preoperative screening for choledocholithiasis prior to cholecystectomy in Chinese patients.Figure 4,Table 6,Reference 13.