Predictive factors for synchronous common bile duct stone in patients with symptomatic cholelithiasis.
Article
Dans Anglais
| IMSEAR
| ID: sea-42595
ABSTRACT
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 analysedRESULTS:
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 predictive value for the presence of CBD stones in patients aged > or = 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 phosphatase (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 appropriate use of pre-operative ERCP in patients who have symptomatic gallstones with a suspected CBD stone prior to cholecystectomy.
Texte intégral:
Disponible
Indice:
IMSEAR (Asie du Sud-Est)
Sujet Principal:
Thaïlande
/
Indice de gravité de la maladie
/
Sujet âgé de 80 ans ou plus
/
Sujet âgé
/
Soins préopératoires
/
Femelle
/
Humains
/
Mâle
/
Lithiase biliaire
/
Comorbidité
Type d'étude:
Etude d'étiologie
/
Etude d'incidence
/
Étude observationnelle
/
Étude pronostique
/
Facteurs de risque
Limites du sujet:
Aged80
Pays comme sujet:
Asie
langue:
Anglais
Année:
2004
Type:
Article
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