title: The role of endoscopic retrograde cholangiopancreatography in perioperative period of laparoscopic cholecystectomy.
abstract: OBJECTIVE
  To explore the indications and the value of endoscopic retrograde cholangiopancreatography (ERCP) in perioperative phase of laparoscopic cholecystectomy.
  
  
  METHODS
  From January 1998 to April 1999, a total of 1500 consecutive laparoscopic cholecystectomies were analyzed. The indications for preoperative group (n=33) included elevated bilirubin level and alkaline phosphatase level, jaundice, pancreatitis, abnormal liver function, dilated bile duct and/or stones on ultrasound or CT. The indications for postoperative group (n=20) included clinical signs or symptoms as well as common bile duct stones demonstrated by intraoperative cholangiography.
  
  
  RESULTS
  Preoperative ERCP for 32 patients (2.1%) showed abnormalities in 12 (37%). Postoperative ERCP for 20 patients (1.3%) demonstrated abnormalities in 14 (70%). Super-selected criteria for preoperative ERCP would predict more than 66% ductal stones. Endoscopic sphincterectomy and duct stones clearance were performed in all 16 patients with documented common bile duct stones. The morbidity was confined in 2 patients with self-limited pancreatitis (3%).
  
  
  CONCLUSIONS
  Using super-selected criteria to select patients for preoperative ERCP can avoid unnecessary ERCP. As soon as postoperative patients have clinical signs or symptoms, endoscopic treatment should be performed.
authors: Department of Surgery, Ruijin Hospital, Shanghai Second Medical University, Shanghai 200025, China. wuweize@hotmail.com
authors: Wei-Ze
authors: WZ
authors: Wu
authors: Ming-Hua
authors: MH
authors: Zheng
authors: Jian-Cheng
authors: JC
authors: Wang
authors: Sheng
authors: S
authors: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde; D017081:Cholecystectomy, Laparoscopic; D041761:Cholecystolithiasis / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care