Endoscopic sphincterotomy in 100 patients scheduled for laparoscopic cholecystectomy: ultrasound evaluation.
OBJECTIVE
The aim of the study was to determine to what extent ultrasonography may monitor the process of sphincterotomy and its effectiveness. The study also aimed at determining the sensitivity and specificity of ultrasonography in detecting choledocholithiasis, in comparison with the results of endoscopic retrograde cholangiopancreatography.


METHODS
Between January 1995 and June 2001, endoscopic sphincterotomy was performed on 100 patients with suspected synchronous choledocholithiasis in preparation for laparoscopic cholecystectomy. The main parameters evaluated in the ultrasonography image included the breadth of the common bile duct and absence or presence of concrements in bile ducts before and after sphincterotomy.


RESULTS
Applied before the endoscopic operation, ultrasonography revealed choledocholithiasis in 58 patients and dilatation of the common bile duct in 95 patients. Endoscopic retrograde cholangiopancreatography confirmed choledocholithiasis in 74 patients, after sphincterotomy concrements were removed in 63 persons. In 26 patients sphincterotomy was performed for stenosis of Vater's papilla. Patients with the breadth of the duct > 10 mm, were referred to a check-up examination.


CONCLUSIONS
Compared with endoscopic retrograde cholangiopancreatography, ultrasonography correctly specifies the breadth of the bile duct and properly monitors the process of endoscopic sphincterotomy, but is less accurate in determining the occurrence of choledocholithiasis, and sensitivity in the test amounted to 73%, and specificity of the examination--84.5%.
Cwik
Grzegorz
G
2nd Department of General Surgery, Medical University of Lublin, Str. Staszica 16, 20-081 Lublin, Poland. grzegorzcwik@poczta.fm
Wallner
Grzegorz
G
Ciechanski
Aleksander
A
Zinkiewicz
Krzysztof
K
Zgodzinski
Witold
W
Polkowski
Wojciech
W
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001652:Bile Ducts / Q000000981:diagnostic imaging; D002760:Cholangiopancreatography, Endoscopic Retrograde; D017081:Cholecystectomy, Laparoscopic; D042883:Choledocholithiasis / Q000000981:diagnostic imaging; D003135:Common Bile Duct / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D016717:Sphincterotomy, Endoscopic; D014463:Ultrasonography