Sw. Galloway et al., SELECTIVE CHOLANGIOGRAPHY WITH LAPAROSCOPIC CHOLECYSTECTOMY - REVIEW OF A PROTOCOL, The European journal of surgery, 162(5), 1996, pp. 373-378
Objective: To report the results of a protocol for the preoperative di
agnosis of stones in the common bile duct in patients with symptomatic
cholelithiasis.Design: Prospective open study. Setting: District gene
ral hospital, United Kingdom. Interventions: Ultrasonography and liver
function tests, and in selected patients preoperative cholangiography
. Main outcome measures: The ability of the investigations to diagnose
stones in the common bile duct preoperatively. Results: Ultrasonograp
hy or liver function tests, or both indicated that 53 patients were at
low risk of having stones in the common duct, and they underwent lapa
roscopic cholecystectomy without further investigation. A further 38 p
atients had minor abnormalities on the first two investigations and un
derwent intravenous cholangiography; ductal stones were identified in
6. Nine patients were thought to be at high risk and so underwent endo
scopic retrograde cholangiopancreatography (ERCP) or open exploration
of the common bile duct, and stones were found in 5. No further stones
have been identified after a minimum follow up of 12 months. Conclusi
on: Selective preoperative cholangiography is a reliable way of detect
ing stones in the common bile duct before laparoscopic cholecystectomy
.