[Spiral CT cholangiography is not suitable for routine diagnosis before laparoscopic cholecystectomy].
BACKGROUND
The purpose of this prospective controlled study was to evaluate the diagnostic potential of spiral computed tomographic (CT) cholangiography in patients undergoing laparoscopic cholecystectomy.


METHODS
60 patients (17 men, 43 women, mean age 54.5 years, range 15-84 years) with symptomatic cholecystolithiasis were included in this study. After infusion of meglumine jodoxamate, all patients underwent upper abdominal spiral CT. The results of the spiral CT scan were then compared with endoscopic retrograde cholangiography (ERC) or intraoperative cholangiography.


RESULTS
In 53 patients (88%) CT cholangiography was considered to be technically adequate for interpretation, but was suboptimal in 4 patients (7%) and nondiagnostic in 3 patients (5%), respectively. CT cholangiography showed a stone free common bile duct in 51 patients which was correct in all cases. CT cholangiography predicted a common bile duct stone in 6 patients which proved to be correct in 4 patients but was found to be incorrect in 2 patients.


CONCLUSIONS
Spiral CT cholangiography is useful for the diagnosis of common bile duct stones. Because of the low positive predicting value routine use before laparoscopic cholecystectomy is not justified.
2. Chirurgische Abteilung und Ludwig Boltzmann Institut für Operative Laparoskopie, Allgemein Offentliches Krankenhaus Linz, Osterreich.
A
A
Shamiyeh
R
R
Rieger
P
P
Schrenk
E
E
Lindner
W
W
Wayand
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016477:Artifacts; D001663:Bilirubin / Q000097:blood; D002758:Cholangiography; D002760:Cholangiopancreatography, Endoscopic Retrograde; D017081:Cholecystectomy, Laparoscopic; D002769:Cholelithiasis / Q000097:blood / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D005260:Female; D042882:Gallstones / Q000097:blood / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods
D001663:Bilirubin