Triple non-invasive diagnostic test for exclusion of common bile ducts stones before laparoscopic cholecystectomy.
OBJECTIVE
To evaluate the impact of a preoperative "triple non-invasive diagnostic test" for diagnosis and/or exclusion of common bile duct stones.


METHODS
All patients with symptomatic gallstone disease, operated on by laparoscopic cholecystectomy from March 2004 to March 2006 were studied retrospectively. Two hundred patients were included and reviewed by using a triple diagnostic test including: patient's medical history, routine liver function tests and routine ultrasonography. All patients were followed up 2-24 mo after surgery to evaluate the impact of triple diagnostic test.


RESULTS
Twenty-five patients were identified to have common bile duct stones. Lack of history of stones, negative laboratory tests and normal ultrasonography alone was proven to exclude common bile duct stones in some patients. However, a combination of these three components (triple diagnostic), was proven to be the most statistically significant test to exclude common bile duct stones in patients with gallstone disease.


CONCLUSIONS
Using a combination of routinely used diagnostic components as triple diagnostic modality would increase the diagnostic accuracy of common bile duct stones preoperatively. This triple non-invasive test is recommended for excluding common bile duct stones and to identify patients in need for other investigations.
Pourseidi
Bahram
B
Department of General & Orthopedic Surgery, Kungalv Hospital, S-442 83 KUNGALV, Sweden.
Khorram-Manesh
Amir
A
D000328:Adult; D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde; D049448:Cholangiopancreatography, Magnetic Resonance; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D042882:Gallstones / Q000000981:diagnostic imaging*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008111:Liver Function Tests; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography