title: Indication of endoscopic retrograde cholangiography by noninvasive predictive factors of common bile duct stones before laparoscopic cholecystectomy: a prospective clinical study.
abstract: OBJECTIVE
  To evaluate the reliability of a screening method in patients with common bile duct (CBD) stones before laparoscopic cholecystectomy (LC) based on predictive factors, and to determine the cases for which preoperative therapeutic endoscopic retrograde cholangiography (ERC) is indicated.
  
  
  METHODS
  Alkaline phosphatase, total bilirubin, amylase, and dilation of CBD results were defined as predictive factors for CBD stones. In cases in which all these 4 factors were negative, preoperative ERC was omitted, and in cases in which 1 of the 4 factors was positive, ERC was performed before LC.
  
  
  RESULTS
  A total of 323 patients (83.7%) in whom all 4 factors were negative, ERC was omitted. In all the 63 patients (16.3%) in whom 1 of the 4 factors was positive, ERC was performed. In 52 (82.5%) of them, CBD stones were present and in 43 of them, LC was performed after endoscopic choledocholithotomy.
  
  
  CONCLUSIONS
  For cases in which any 1 of the 4 factors was positive before LC, it was strongly recommended to perform preoperative ERC.
authors.affiliation: Department of Surgery, Tokyo Women's Medical University, Medical Center East, Tokyo, Japan. tansiosu@gmail.com
authors.forename: Shunichi
authors.initials: S
authors.lastname: Shiozawa
authors.forename: Dal Ho
authors.initials: DH
authors.lastname: Kim
authors.forename: Takebumi
authors.initials: T
authors.lastname: Usui
authors.forename: Akira
authors.initials: A
authors.lastname: Tsuchiya
authors.forename: Toshio
authors.initials: T
authors.lastname: Masuda
authors.forename: Satoshi
authors.initials: S
authors.lastname: Inose
authors.forename: Masaki
authors.initials: M
authors.lastname: Aizawa
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Yoshimatsu
authors.forename: Takao
authors.initials: T
authors.lastname: Katsube
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Naritaka
authors.forename: Kenji
authors.initials: K
authors.lastname: Ogawa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase; D001663:Bilirubin; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000295:instrumentation / Q000379:methods*; D017081:Cholecystectomy, Laparoscopic / Q000295:instrumentation / Q000379:methods*; D003135:Common Bile Duct / Q000601:surgery*; D005260:Female; D042882:Gallstones / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D000469:Alkaline Phosphatase; D001663:Bilirubin