Selection criteria for preoperative endoscopic retrograde cholangiopancreatography before laparoscopic cholecystectomy and endoscopic treatment of bile duct stones: results of a retrospective, single center study between 1996-2002.

Content Provider	Semantic Scholar
Author	Lakatos, László Péter Mester, Gábor Reti, Gyorgy Nagy, Attila Cs Lakatos, Peter L.
Copyright Year	2004
Abstract	AIM The optimal treatment for bile duct stones (in terms of cost, complications and accuracy) is unclear. The aim of our study was to determine the predictive factors for preoperative endoscopic retrograde cholangiopancreatography (ERCP). METHODS Patients undergoing preoperative ERCP (< or =90 d before laparoscopic cholecystectomy) were evaluated in this retrospective study from the 1st of January 1996 to the 31st of December 2002. The indications for ERCP were elevated serum bilirubin, elevated liver function tests (LFT), dilated bile duct (> or =8 mm) and/or stone at US examination, coexisting acute pancreatitis and/or acute pancreatitis or jaundice in patient's history. Suspected prognostic factors and the combination of factors were compared to the result of ERCP. RESULTS Two hundred and six preoperative ERCPs were performed during the observed period. The rate of successful cannulation for ERC was (97.1%). Bile duct stones were detected in 81 patients (39.3%), and successfully removed in 79 (97.5%). The number of prognostic factors correlated with the presence of bile duct stones. The positive predictive value for one prognostic factor was 1.2%, for two 43%, for three 72.5%, for four or more 91.4%. CONCLUSION Based on our data preoperative ERCP is highly recommended in patients with three or more positive factors (high risk patients). In contrast, ERCP is not indicated in patients with zero or one factor (low risk patients). Preoperative ERCP should be offered to patients with two positive factors (moderate risk patients), however the practice should also be based on the local conditions (e.g. skill of the endoscopist, other diagnostic tools).
Starting Page	1
Ending Page	17
Page Count	17
File Format	PDF HTM / HTML
Alternate Webpage(s)	https://core.ac.uk/download/pdf/11855837.pdf
PubMed reference number	15526372v1
Volume Number	10
Issue Number	23
Journal	World journal of gastroenterology
Language	English
Access Restriction	Open
Subject Keyword	Acute pancreatitis Arabic numeral 0 Bile Duct Diseases Bile duct calculus Bile duct carcinoma Bile duct structure Bilirubin Calculi Cannulation Cholecystectomy procedure Cholecystectomy, Laparoscopic Endoscopic Retrograde Cholangiopancreatography Endoscopic retrograde cholangiography Icterus Liver Function Tests Patients Positive Predictive Value of Diagnostic Test Prognostic Factors Seventy Nine
Content Type	Text
Resource Type	Article