Document Detail


Low incidence of retained common bile duct stones using a selective policy of biliary imaging.
MedLine Citation:
PMID:  16245655     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: Biliary imaging has decreased since the advent of laparoscopic cholecystectomy. This study aimed to examine the incidence of retained common bile duct (CBD) stones, using a selective policy of biliary imaging. METHODS: A prospective computerised database was used to study patients who underwent laparoscopic cholecystectomy by one surgeon over 36 months. Two hundred and thirty-five patients (191 female, 44 male) were operated on. Ages ranged from 15 to 82 years (mean 47 years). Follow-up periods ranged from six to 39 months (mean 23.3 months). Selection for pre-operative endoscopic retrograde cholangiopacreatogram (ERCP), intraoperative cholangiography (IOC) or neither depended on liver function tests (LFTs) and CBD diameter on ultrasound prior to surgery. If LFTs were persistently raised and/or the CBD was dilated on ultrasound, patients underwent pre-operative ERCP. If LFTs were raised, and returned to normal promptly, IOC was performed. RESULTS: Of 235 patients, 26 had pre-operative ERCP, 62 had IOC and 157 had neither. Ten patients had both ERCP and IOC. To date, one patient (0.43%) has radiologically-proven unsuspected retained CBD stones; these were successfully treated with ERCP. CONCLUSION: Selective biliary imaging in patients undergoing laparoscopic cholecystectomy is safe. This process identifies the majority of patients with ductal calculi and minimises the need for unnecessary ERCP and peroperative cholangiography.
Authors:
N Nugent; M Doyle; K Mealy
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland     Volume:  3     ISSN:  1479-666X     ISO Abbreviation:  Surgeon     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-10-25     Completed Date:  2005-11-10     Revised Date:  2007-03-02    
Medline Journal Info:
Nlm Unique ID:  101168329     Medline TA:  Surgeon     Country:  Scotland    
Other Details:
Languages:  eng     Pagination:  352-6     Citation Subset:  IM    
Affiliation:
Department of Surgery, Wexford General Hospital, Wexford, Ireland. nnugent@vodafone.ie
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MeSH Terms
Descriptor/Qualifier:
Algorithms
Cholangiography*
Cholangiopancreatography, Endoscopic Retrograde*
Cholecystectomy, Laparoscopic / methods*
Cholecystolithiasis / surgery*
Common Bile Duct / pathology
Dilatation, Pathologic
Female
Gallstones / radiography*
Humans
Intraoperative Period
Liver Function Tests
Male
Prospective Studies
Comments/Corrections
Comment In:
Surgeon. 2006 Dec;4(6):388   [PMID:  17162742 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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