Views: 1,681 | Downloads:
32
| Responses: 0
| XML | Respond to this article | Alert & updates | Request permissions | Email to a friend |
Original ArticleOpen Access
Predictive Factors for Synchronous Common Bile Duct Stone in Patients with Symptomatic Cholelithiasis
Charatcharoenwitthaya P 
,
Sattawatthamrong Y ,
Manatsathit S ,
Tanwandee T ,
Leelakusolvong S ,
Kachintorn U ,
Leungrojanakul P ,
Boonyapisit S ,
Pongprasobchai S
,
Sattawatthamrong Y ,
Manatsathit S ,
Tanwandee T ,
Leelakusolvong S ,
Kachintorn U ,
Leungrojanakul P ,
Boonyapisit S ,
Pongprasobchai S YUDHTANA SATTA WATTHAMRONG, MD*,
TAWESAK TANWANDEE,MD*,
UDOM KACHINTORN, MD*,
SASIPRAPA BOONYAPISIT, MD*,
Background : Laparoscopic cholecystectomy (LC) has become the treatment of choice for
patients with symptomatic cholelithiasis. About 8-15 per cent of patients with symptomatic gallstones
may bear associated common bile duct (CBD) stones, The management of choledocholithiasis in the
laparoscopic era remain debatable. Although pre-operative endoscopic cholangiopancreatography
(ERCP) is available and highly accurate in the detection of CBD stones, its routine use is controversial
because of its inherent disadvantages.
Objective : The aim of this retrospective study was to generate an effective predictive model
for bile duct stones detection by pre-operative ERCP.
Method : Twelve pre-operative clinical, biochemical and sonographic variables from 206
consecutive patients who underwent pre-operative ERCP with LC for gallstones with/without CBD
stones from October 1998 to December 2000 were retrospectively analysed
Results : 143 of the 206 patients with gallstones were found to have CBD stones. The mean
age was 61 (20-93) yr old, and 55.9 per cent were female. Multivariate analysis showed a high predic-
tive value for the presence of CBD stones in patients aged ;:::, 55 yr old (Odd radio (OR) 1.03, 95%
confidence interval (95% CI) 1.01-1.05), jaundice (OR 2.7, 95% CI 1.7-4.8), elevated alkaline phos-
phatase (OR 1.002, 95% CI 1.000-1.005), CBD dilatation on ultrasound (OR 3.8, 95% CI 1.8-8) and
CBD stone on ultrasound.
Conclusion : The important clinical presentations and investigating could allow more appro-
priate use of pre-operative ERCP in patients who have symptomatic gallstones with a suspected CBD
stone prior to cholecystectomy.
Key word : Predictive, Common Bile Duct Stone, Cholelithiasis, ERCP
TAWESAK TANWANDEE,MD*,
UDOM KACHINTORN, MD*,
SASIPRAPA BOONYAPISIT, MD*,
Background : Laparoscopic cholecystectomy (LC) has become the treatment of choice for
patients with symptomatic cholelithiasis. About 8-15 per cent of patients with symptomatic gallstones
may bear associated common bile duct (CBD) stones, The management of choledocholithiasis in the
laparoscopic era remain debatable. Although pre-operative endoscopic cholangiopancreatography
(ERCP) is available and highly accurate in the detection of CBD stones, its routine use is controversial
because of its inherent disadvantages.
Objective : The aim of this retrospective study was to generate an effective predictive model
for bile duct stones detection by pre-operative ERCP.
Method : Twelve pre-operative clinical, biochemical and sonographic variables from 206
consecutive patients who underwent pre-operative ERCP with LC for gallstones with/without CBD
stones from October 1998 to December 2000 were retrospectively analysed
Results : 143 of the 206 patients with gallstones were found to have CBD stones. The mean
age was 61 (20-93) yr old, and 55.9 per cent were female. Multivariate analysis showed a high predic-
tive value for the presence of CBD stones in patients aged ;:::, 55 yr old (Odd radio (OR) 1.03, 95%
confidence interval (95% CI) 1.01-1.05), jaundice (OR 2.7, 95% CI 1.7-4.8), elevated alkaline phos-
phatase (OR 1.002, 95% CI 1.000-1.005), CBD dilatation on ultrasound (OR 3.8, 95% CI 1.8-8) and
CBD stone on ultrasound.
Conclusion : The important clinical presentations and investigating could allow more appro-
priate use of pre-operative ERCP in patients who have symptomatic gallstones with a suspected CBD
stone prior to cholecystectomy.
Key word : Predictive, Common Bile Duct Stone, Cholelithiasis, ERCP
Download:
PDF