Selective endoscopic cholangiography for the detection of common bile duct stones in patients with cholelithiasis

摘要: Background and study aims The detection management of common bile duct (CBD) stones in patients undergoing laparoscopic cholecystectomy continues to be controversial. Several diagnostic therapeutic strategies have been suggested. These include intraoperative cholangiography, selective endoscopic retrograde cholangiopancreatography (ERCP), magnetic resonance cholangiopancreatography, ultrasonography. aim this was evaluate the efficacy ERCP detecting CBD with cholelithiasis before cholecystectomy. Patients methods In a prospective study, who presented during 6-year period were assessed on basis for suspected carried out if patient had any following criteria: dilated ultrasound, gallstone pancreatitis, or abnormal liver function tests. Intraoperative cholangiography not performed patients. Long-term follow-up undertaken. Results included 427 On criteria, 41 (9.6 %), confirmed 22 cases (53.7 %). most useful predictor presence association situation, identified 14 17 (82 Abnormal tests alone sensitivity 50 % (four eight). All other parameters used isolation lower rate. During median 6 years (range 1-10 years), six 386 (1.6 %) initially normal imaging biochemical again retained stones. successfully managed by sphincterotomy. There no major complications. Conclusions Preoperative is effective clinically significant However, there high false-negative rate when single criterion guide therapy. Multivariate analysis preoperative risk stratification, conjunction modalities, may make it possible minimize unnecessary ERCPs.