American Society of Gastrointestinal Endoscopy
A proposed strategy to assign risk of choledocholithiasis in patients with symptomatic cholelithiasis based on clinical predictors

                      Definition.            Symbol

High quality (++++)
Further research
is very unlikely
to change our
confidence in the
estimate of effect.
Moderate quality. (+++)
Further research
is likely to have an important
impact on our confidence
in the estimate of effect
and may change the estimate.

Low quality. (++)
Further research is very likely to

have an important
impact on our confidence
in the estimate of effect
and is likely to change the estimate

Very low quality. (++)

Any estimate of effect is very
uncertain.

  Predictors of choledocholithiasis13,14,29,31,32 Very strong

CBD stone on transabdominal US Clinical ascending cholangitis Bilirubin O4 mg/dL
Strong
Dilated CBD on US (O6 mm with gallbladder in situ)
Bilirubin level 1.8-4 mg/dL Moderate
Abnormal liver biochemical test other than bilirubin
Age older than 55 y
Clinical gallstone pancreatitis