| Evaluation of the predictors of choledocholithiasis: comparative analysis of clinical, biochemical, radiological, radionuclear, and intraoperative parameters. | |
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MedLine Citation:
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PMID: 11291704 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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This prospective study was performed to assess the predictive ability of the various indicators of common bile duct (CBD) calculi, individually or in combination, by analyzing 88 patients with gallstone disease. The patients were classified into two groups according to the presence of 10 predefined criteria. Of 53 patients with one or more risk factors (group 2), 26 harbored CBD calculi; none of 35 patients with no risk factors (group 1) had CBD stones. Jaundice correlated best, with a sensitivity of 69%; and pancreatitis had the lowest sensitivity (12%). Elevated serum bilirubin and alkaline phosphatase levels correlated better than liver enzymes and serum amylase. The sensitivity and negative predictive value of cholescintigraphy scanning for diagnosing CBD calculi were better than those of ultrasonography, the sensitivity being 84% versus 50% and the negative predictive value 95% versus 82%. Endoscopic retrograde cholangiopancreaticography was successful in 94% of the patients, and CBD calculi were diagnosed in 74%. Moreover, peroperative cholangiography was 100% sensitive with no false-positive results. Ultimately, a palpable stone at surgery was the best predictor. When all the criteria were analyzed, it was found that as the number of criteria increased so did the percentage of patients harboring CBD calculi. |
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Authors:
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S M Bose; A Mazumdar; V S Prakash; R Kocher; S Katariya; C M Pathak |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Surgery today Volume: 31 ISSN: 0941-1291 ISO Abbreviation: Surg. Today Publication Date: 2001 |
Date Detail:
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Created Date: 2001-04-06 Completed Date: 2001-06-07 Revised Date: 2006-08-03 |
Medline Journal Info:
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Nlm Unique ID: 9204360 Medline TA: Surg Today Country: Japan |
Other Details:
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Languages: eng Pagination: 117-22 Citation Subset: IM |
Affiliation:
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Department of Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Alkaline Phosphatase / blood Bilirubin / blood Cholangiography Cholangiopancreatography, Endoscopic Retrograde* Cholelithiasis / complications* False Positive Reactions Female Gallstones / diagnosis, etiology* Humans Jaundice / complications Male Middle Aged Physical Examination Predictive Value of Tests Risk Factors Sensitivity and Specificity |
| Chemical | |
Reg. No./Substance:
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635-65-4/Bilirubin; EC 3.1.3.1/Alkaline Phosphatase |
| Comments/Corrections | |
Comment In:
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Surg Today. 2005;35(12):1095-6
[PMID:
16341496
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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