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Surgical Endoscopy

Published in:

01-02-2009

How reliable is intraoperative cholangiography as a method for detecting common bile duct stones?

A prospective population-based study on 1171 patients

Authors: Per Videhult, Gabriel Sandblom, Ib Christian Rasmussen

Published in: Surgical Endoscopy | Issue 2/2009

Abstract

Background

Although intraoperative cholangiography (IOC) is a widely used method for detecting common bile duct stones (CBDS), its accuracy has not been fully evaluated in large nonselected patient samples. The purpose of this study was to assess the sensitivity, specificity and predictive value of dynamic IOC regarding its ability to diagnose CBDS in a population-based setting, and to assess the morbidity associated with the investigation.

Methods

All patients operated on for gallstone disease between 2003 and 2005 in the county of Uppsala in Sweden, a county with a population of 302,000 in December 2004, were registered prospectively. The outcome of cholangiography was validated against the postoperative clinical course.

Results

1171 patients were registered, and among these IOC was performed in 1117 patients (95%). Common bile duct stones were found in 134 patients (11%). One perforation of the common bile duct caused by the IOC catheter was recorded. Sensitivity was 97%, specificity 99%, negative predictive value 99%, positive predictive value 95%, and overall accuracy 99%. In 7 of the 134 cases where IOC indicated CBDS, no stones could be verified on exploration. In 4 of the 979 cases where IOC was normal, the clinical course indicated overlooked CBDS.

Conclusion

Intraoperative cholangiography is a safe and accurate method for detecting common bile duct stones.

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Title: How reliable is intraoperative cholangiography as a method for detecting common bile duct stones?
A prospective population-based study on 1171 patients
Authors: Per Videhult
Gabriel Sandblom
Ib Christian Rasmussen
Publication date: 01-02-2009
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 2/2009
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-008-9883-2

At a glance: The STEP trials

Springer Medicine

How reliable is intraoperative cholangiography as a method for detecting common bile duct stones?

A prospective population-based study on 1171 patients

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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