Featured Research

from universities, journals, and other organizations

Exclusion Of Common Bile Duct Stones Prior To Gallstone Operations

Date:
October 31, 2007
Source:
World Journal of Gastroenterology
Summary:
In the era of laparoscopic surgery, intra-operative X-ray investigation of bile ducts to identify coexisting common bile duct stones has been replaced by new techniques, which, unfortunately, are either too expensive and not available to all patients, or invasive and may result in severe complications. A study recently reported may offer a simple and available measure to solve this problem worldwide.

In the era of laparoscopic surgery, intra-operative X-ray investigation of bile ducts to identify coexisting common bile duct stones has been replaced by new techniques, which, unfortunately, are either too expensive and not available to all patients, or invasive and may result in severe complications. A study recently reported may offer a simple and available measure to solve this problem worldwide.

Related Articles


CBDS occur in 7-20% of all patients undergoing a gallstone operation and may complicate the course of surgery. Although intraoperative x-ray investigation was routinely performed to diagnose CBDS in the pre-laparoscopic era, its use during the laparoscopic era has been debated.

Consequently, other techniques for diagnosing CBDS have been introduced. For example, preoperative liver function test (LFT; s-bilirubin and s-ALP) results, if abnormal, might be diagnostic for CBDS. However, some patients might have normal LFT despite coexisting CBDS. Ultrasonography is the major diagnostic modality used to diagnose gallstones, but is less helpful for diagnosing CBDS.

Computed tomography is rarely useful for diagnosing gallstones. Magnetic-resonance-cholangio-pancreatography (MRCP) has high specificity and sensitivity, with accuracy similar to that of ERCP (Endoscopic-Retrograde-Cholangio-Pancreatography), but its accuracy depends on the size and anatomical location of a gallstone. In addition, MRCP is not widely available, and unlike ERCP, does not allow the endoscopic extraction of stones. ERCP is the most common technique used for both the diagnosis and treatment of CBDS. It is, however, expensive, invasive, technically demanding and associated with small but significant morbidity.

In this article, 200 consecutive patients with symptomatic gallstones disease operated on by laparoscopic cholecystectomy were retrospectively included and followed up 2-24 months after surgery. Three simple and routinely performed diagnostic variables, i.e., clinical history of patient (history of jaundice, pancreatitis or cholangitits), abnormal LFT results and/or dilated common bile duct (either alone or in combination), for diagnosing/excluding CBDS were evaluated. The results were statistically analyzed by calculating the sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) of each with special attention given to NPV, which is the proportion of patients with negative test results who are correctly diagnosed. Higher NPV indicates higher sensitivity for excluding CBDS.

Twenty five patients were found to have CBDS (12.5%). As a single diagnostic test, ultrasonography showed higher sensitivity, specificity, and negative/positive predictive values than both medical history and LFT. As a triple diagnostic modality, the combination of medical history, ultrasonographic findings, and LFT results was shown to be the best diagnostic modality to exclude CBDS (NPV of 97. 3 %).

The authors concluded that using a combination of three routinely used diagnostic components as a triple diagnostic modality can increase the diagnostic accuracy of CBDS. This test is recommended for excluding CBDS and to identify patients in need of other investigations, such as MRCP or ERCP. The availability and non-invasiveness of this triple diagnostic test are additional benefits.

Journal reference: Pourseidi B, Khorram-Manesh A. Triple non-invasive diagnostic test for exclusion of common bile ducts stones before laparoscopic cholecystectomy. World J Gastroenterol 2007; 13(43): 5745-5749


Story Source:

The above story is based on materials provided by World Journal of Gastroenterology. Note: Materials may be edited for content and length.


Cite This Page:

World Journal of Gastroenterology. "Exclusion Of Common Bile Duct Stones Prior To Gallstone Operations." ScienceDaily. ScienceDaily, 31 October 2007. <www.sciencedaily.com/releases/2007/10/071031085140.htm>.
World Journal of Gastroenterology. (2007, October 31). Exclusion Of Common Bile Duct Stones Prior To Gallstone Operations. ScienceDaily. Retrieved January 31, 2015 from www.sciencedaily.com/releases/2007/10/071031085140.htm
World Journal of Gastroenterology. "Exclusion Of Common Bile Duct Stones Prior To Gallstone Operations." ScienceDaily. www.sciencedaily.com/releases/2007/10/071031085140.htm (accessed January 31, 2015).

Share This


More From ScienceDaily



More Health & Medicine News

Saturday, January 31, 2015

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

CDC: Get Vaccinated for Measles

CDC: Get Vaccinated for Measles

Reuters - US Online Video (Jan. 30, 2015) The CDC is urging people to get vaccinated for measles amid an outbreak that began at Disneyland and has now infected more than 90 people. Linda So reports. Video provided by Reuters
Powered by NewsLook.com
Obama To Outline New Plan For Personalized Medicine

Obama To Outline New Plan For Personalized Medicine

Newsy (Jan. 30, 2015) President Obama is expected to speak with drugmakers Friday about his Precision Medicine Initiative first introduced last week. Video provided by Newsy
Powered by NewsLook.com
NFL Concussions Down; Still on Parents' Minds

NFL Concussions Down; Still on Parents' Minds

AP (Jan. 30, 2015) The NFL announced this week that the number of game concussions dropped by a quarter over last season. Still, the dangers of the sport still weigh on players, and parents&apos; minds. (Jan. 30) Video provided by AP
Powered by NewsLook.com
U.S. Wants to Analyze DNA from 1 Million People

U.S. Wants to Analyze DNA from 1 Million People

Reuters - US Online Video (Jan. 30, 2015) The U.S. has proposed analyzing genetic information from more than 1 million American volunteers to learn how genetic variants affect health and disease. Rough Cut (no reporter narration). Video provided by Reuters
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins