Abnormal common bile duct sonography - The best predictor of choledocholithiasis before laparoscopic cholecystectomy

被引:21
作者
Contractor, QQ
Boujemla, M
Contractor, TQ
ElEssawy, OM
机构
[1] Department of Internal Medicine, Surgery, and Biostatistics, King Fahd Specialist Hospital, Buraidah, Gassim
[2] King Fahd Specialist Hospital, Buraidah, Gassim
关键词
sonography; choledocholithiasis; endoscopic retrograde cholangiopancreatography; laparoscopy; cholecystectomy;
D O I
10.1097/00004836-199709000-00006
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
We conducted a prospective study to determine the most reliable indicator of common bile duct stones before laparoscopic cholecystectomy. One hundred thirty-seven patients were referred for endoscopic retrograde cholangiography before laparoscopic cholecystectomy for suspected choledocholithiasis due to one or more of the following abnormalities: (a) altered liver function tests, (b) increased serum amylase levels, or (c) a dilated common bile duct (>7 mm) with or without evidence of stones on sonography. Sensitivity, specificity, positive and negative predictive values, and the likelihood of the presence or absence of morbidity were calculated for 25 different variables. Common bile duct stones were detected in 63 (46%) patients. Abnormal result of sonography of the common bile duct was the best predictor of choledocholithiasis (p < 0.0001). Abnormalities of the combined liver function tests were statistically significant predictors only when combined with abnormal sonographic results. Improving liver function tests before endoscopy had a significant negative predictive value (p = 0.01). Stepwise logistic regression analysis showed that abnormal ultrasound and the presence of common bile duct stones on ultrasound were significant (p = 0.009 and p = 0.049, respectively). Abnormal result of sonography of the common bile duct is the best predictor of choledocholithiasis before laparoscopic cholecystectomy.
引用
收藏
页码:429 / 432
页数:4
相关论文
共 22 条
[1]   USEFUL PREDICTORS OF BILE-DUCT STONES IN PATIENTS UNDERGOING LAPAROSCOPIC CHOLECYSTECTOMY [J].
BARKUN, AN ;
BARKUN, JS ;
FRIED, GM ;
GHITULESCU, G ;
STEINMETZ, O ;
PHAM, C ;
MEAKINS, JL ;
GORESKY, CA .
ANNALS OF SURGERY, 1994, 220 (01) :32-39
[2]   Intravenous infusion cholangiography for investigation of the bile duct: A direct comparison with endoscopic retrograde cholangiopancreatography [J].
Bloom, ITM ;
Gibbs, SL ;
KeelingRoberts, CS ;
Brough, WA .
BRITISH JOURNAL OF SURGERY, 1996, 83 (06) :755-757
[3]   ERCP, CHOLANGIOGRAPHY, AND LAPAROSCOPIC CHOLECYSTECTOMY - THE SOCIETY-OF-AMERICAN-GASTROINTESTINAL-ENDOSCOPIC-SURGEONS (SAGES) OPINION SURVEY [J].
BRODISH, RJ ;
FINK, AS .
SURGICAL ENDOSCOPY-ULTRASOUND AND INTERVENTIONAL TECHNIQUES, 1993, 7 (01) :3-8
[4]  
Chan ACW, 1996, GASTROINTEST ENDOSC, V43, P212
[5]  
CHANGCHIEN CS, 1995, AM J GASTROENTEROL, V90, P2124
[6]   INTRAOPERATIVE ENDOSCOPIC SPHINCTEROTOMY FOR COMMON BILE-DUCT STONES DURING LAPAROSCOPIC CHOLECYSTECTOMY [J].
DESLANDRES, E ;
GAGNER, M ;
POMP, A ;
RHEAULT, M ;
LEDUC, R ;
CLERMONT, R ;
GRATTON, J ;
BERNARD, EJ .
GASTROINTESTINAL ENDOSCOPY, 1993, 39 (01) :54-58
[7]   MANAGING CHOLEDOCHOLITHIASIS IN THE LAPAROSCOPIC ERA [J].
DUENSING, RA ;
WILLIAMS, RA ;
COLLINS, JC ;
WILSON, SE .
AMERICAN JOURNAL OF SURGERY, 1995, 170 (06) :619-623
[8]   THE ROLE OF ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY IN PATIENTS WITH LAPAROSCOPIC CHOLECYSTECTOMIES [J].
ERICKSON, RA ;
CARLSON, B .
GASTROENTEROLOGY, 1995, 109 (01) :252-263
[9]   DIAGNOSIS OF CHOLEDOCHOLITHIASIS - VALUE OF MR CHOLANGIOGRAPHY [J].
GUIBAUD, L ;
BRET, PM ;
REINHOLD, C ;
ATRI, M ;
BARKUN, ANG .
AMERICAN JOURNAL OF ROENTGENOLOGY, 1994, 163 (04) :847-850
[10]   PREDICTIVE ABILITY OF CHOLEDOCHOLITHIASIS INDICATORS - A PROSPECTIVE EVALUATION [J].
HAUERJENSEN, M ;
KARESEN, R ;
NYGAARD, K ;
SOLHEIM, K ;
AMLIE, E ;
HAVIG, O ;
VIDDAL, KO .
ANNALS OF SURGERY, 1985, 202 (01) :64-68