[Indications for peroperative cholangiography in cholecystectomy].
In a group of 466 cholecystectomies with peroperative cholangiography the authors revealed sensitivity of the examination for cholangiolithiasis (255 before operation) in 95.3%, for diagnosis of all benign diseases of the bile ducts (288 operations) in 95.8%. They established six indication criterias for peroperative cholangiography during cholecystectomy: 1. jaundice or elevated serum bilirubin before operation, 2. pancreatitis or elevated amylase values in blood or urine before operation, 3. elevated alkaline phosphatase (ALP) or gamma-glutamyl transpeptidase (GMT) serum values before operation, 4. small (under 3 mm) or multiple (more than 10) gallstones, 5. a choledochus wider than 10 mm, 6 a cystic duct wider than 3 mm. As indication suffices positivity of one of the criteria. By introducing these indications it was possible to reduce peroperative cholangiography during cholecystectomies by cca 40% with a 0.1% risk of diagnostic errors in the diagnosis of benign diseases of the bile ducts.
Vetyska
J
J
Chirurgické-oddĕlení NsP Na Homolce, Praha.
Krusina
L
L
D002758:Cholangiography; D002763:Cholecystectomy; D002769:Cholelithiasis / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007432:Intraoperative Period; D012680:Sensitivity and Specificity
Indikace k peroperacní cholangiografii pri cholecystektomii.