[ERCP and laparoscopic cholecystectomy].
The use of perioperative endoscopic retrograde cholangiopancreatography (ERCP) for suspected common bile duct stones (CBDS) was investigated retrospectively in 153 of 477 patients undergoing laparoscopic cholecystectomy (LC). Pre- and postoperative ERCP was performed in 141 patients (29.6%) and 12 patients (2.5%), respectively. Successful cannulation of the CBD was achieved in 95%. Preoperative CBDS were found in 40/141 patients (28%), of whom 65% were successfully retracted during one session and 35% during two sessions. Twelve patients underwent postoperative ERCP of whom eight patients had CBDS. The complication rate of preoperative ERCP was 9.9%. There was no mortality. Prediction of CBDS diagnosed by preoperative ERCP, using history, liver biochemistry, ultrasonography and combination of biochemistry and ultrasonography showed values of 2.2%, 37.5%, 33.3% and 55.6%, respectively. The diagnostic and therapeutic success rate of ERCP is acceptable. However, the low rate of CBDS in patients undergoing ERCP preoperatively calls for a more selective use of ERCP in patients undergoing LC. History, liver biochemistry and ultrasonography are inefficient methods of patient selection.
Aalborg Sygehus Syd, kirurgisk gastroenterologisk afdeling.
D A
DA
Andreasen
J F
JF
Larsen
D000293:Adolescent; D000328:Adult; D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011300:Preoperative Care; D011446:Prospective Studies; D012189:Retrospective Studies