| Low incidence of retained common bile duct stones using a selective policy of biliary imaging. | |
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MedLine Citation:
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PMID: 16245655 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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N Nugent; M Doyle; K Mealy |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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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:
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Created Date: 2005-10-25 Completed Date: 2005-11-10 Revised Date: 2007-03-02 |
Medline Journal Info:
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Nlm Unique ID: 101168329 Medline TA: Surgeon Country: Scotland |
Other Details:
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Languages: eng Pagination: 352-6 Citation Subset: IM |
Affiliation:
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Department of Surgery, Wexford General Hospital, Wexford, Ireland. nnugent@vodafone.ie |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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Surgeon. 2006 Dec;4(6):388
[PMID:
17162742
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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