Selective preoperative endoscopic retrograde cholangiopancreatography in laparoscopic biliary surgery.
作者： H. Rijna , P. J. Borgstein , S. G. M. Meuwissen , L. M. de Brauw , N. P. Wildenborg
关键词:
摘要: The management of common bile duct (CBD) stones in patients subjected to laparoscopic cholecystectomy is still a subject debate. A prospective study was performed all 699 with symptomatic gallstones at risk CBD between mid-1987 and 1994. Based on clinical, biochemical ultrasonographic criteria, 119 underwent preoperative endoscopic retrograde cholangiopancreatography (ERCP) or without sphincterotomy. Results showed high positive predictive value (over 85 per cent) for the presence acute cholangitis, persistent obstructive jaundice phase gallstone pancreatitis. In other groups (increased liver enzyme levels, wide after resolution pancreatitis) less than 25 cent. complication rate ERCP sphincterotomy 14 cent mortality 2 These results argue more selective use only Other harbouring should undergo intraoperative cholangiography and, if are found, exploration postoperative ERCP.
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