Selective cholangiography with laparoscopic cholecystectomy: review of a protocol.
OBJECTIVE
To report the results of a protocol for the preoperative diagnosis of stones in the common bile duct in patients with symptomatic cholelithiasis.


METHODS
Prospective open study.


METHODS
District general hospital, United Kingdom.


METHODS
Ultrasonography and liver function tests, and in selected patients preoperative cholangiography.


METHODS
The ability of the investigations to diagnose stones in the common bile duct preoperatively.


RESULTS
Ultrasonography or liver function tests, or both indicated that 53 patients were at low risk of having stones in the common duct, and they underwent laparoscopic cholecystectomy without further investigation. A further 38 patients had minor abnormalities on the first two investigations and underwent intravenous cholangiography; ductal stones were identified in 6. Nine patients were thought to be at high risk and so underwent endoscopic retrograde cholangiopancreatography (ERCP) or open exploration of the common bile duct, and stones were found in 5. No further stones have been identified after a minimum follow up of 12 months.


CONCLUSIONS
Selective preoperative cholangiography is a reliable way of detecting stones in the common bile duct before laparoscopic cholecystectomy.
Galloway
S W
SW
Department of Surgery, Cheltenham General Hospital, England.
Blazeby
J M
JM
Tulloh
B R
BR
Poskitt
K R
KR
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002758:Cholangiography; D017081:Cholecystectomy, Laparoscopic; D002769:Cholelithiasis / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D042882:Gallstones / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D014463:Ultrasonography