A colangiografia peroperatória

Bastos, Eduardo Lemos de Souza; Micheloni, Paulo Roberto Teixeira; Silvado, Rubens Augusto Brazil

doi:10.1590/s0100-69911998000400007

Cited by 2 publications

(3 citation statements)

References 6 publications

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“…According to the presented series, with two X-rays has found to recognize most of the changes. It is possible: 1) to evaluate the anatomy of the entire biliary tree; 2) to identify unsuspected gallstones in the biliary tract; 3) to recognize intraluminal content in large and small overpressure after emptying; 4) to do immediate identification of any injuries; 5) to recognize patency, shape, capacity and diseases of the duodenal papilla; 6) to document the biliary tract 1,2,11 . The advantages are: 1) allows repetition, like all other forms of intraoperative radiographic study; 2) saves a radiograph; 3) decreases the time of anesthesia and radiological work-up; 4) allows radiomanometric study; 5) decreases exposure to X-ray; 6) less access and less handling time by the technician, with less risk of infection.…”

Section: Discussionmentioning

confidence: 99%

“…On July 15, 1867, John S.Bobs, believing that the removal of the gallstone would be the treatment for biliary disease, performed the first successful cholecystostomy. With the idea that the withdrawal of the gallstones with the maintenance of the gallbladder would not be the definitive treatment, Carl Langenbuch made the first successful cholecystectomy on July 5, 1882 1 . On June 18, 1931, Pablo Luis Mirizzi made the first intraoperative cholangiography (CT) and drew attention to it in articles published in several languages, motivating its use in routine management of biliary tree 3,7,8,10 .…”

Section: Introductionmentioning

confidence: 99%

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Nova opção técnica para colangiografia transoperatória

Silva¹,

Portela²

2011

ABCD, arq. bras. cir. dig.

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-Background -First described 70 years ago, intraoperative cholangiography is an effective method of study of the biliary tract. There are several ways of its realization. Aim -To add a new technique of cholangiography in relation to the classical one using only two radiographs for static and dynamic interpretation. Methods -Cholangiography is made with two X-rays, the first with overpressure and the second three minutes later, in emptying time. It was performed on 39 patients with gallstones undergoing cholecystectomy by laparotomy. The evaluation of the radiographs was based on a radiographic classification created by the authors, varying in degrees in the overpressure from 0 to 3 and emptying of 1 to 3. Results -The complete or almost complete filling of the biliary tree was found in 66.7% of patients in the phase of overpressure. In the emptying phase, 59% of patients had 1/3 or less contrast on biliary tree. There was a need to add additional radiographs in 5% of patients after seven minutes, with complete emptying. Conclusion -The proposed technique proved feasible, simple, fast and effective. ABCDDV/799RESUMO -Racional -Descrita há mais de 70 anos, a colangiografia transoperatória é método eficaz de estudo da via biliar. Existem diversas formas de sua realização. Objetivo -Acrescentar uma nova forma de colangiografia em relação à técnica clássica usando somente duas radiografias para interpretação estática e dinâmica. Métodos -A colangiografia é feita com duas radiografias, a primeira em hiperpressão e a segunda três minutos após, em esvaziamento. Ela foi realizada em 39 pacientes portadores de colecistolitíase, submetidos à colecistectomia por laparotomia. A avaliação dos radiogramas foi feita com base em uma classificação radiográfica, criada pelos autores em graus que variam na hiperpressão de 0 a 3 e no esvaziamento de 1 a 3. Resultados -O enchimento total ou quase total da árvore biliar foi encontrado em 66,7% dos pacientes na fase de hiperpressão. Na fase de esvaziamento, 59% dos pacientes estavam com um terço ou menos de contraste. Houve a necessidade de acrescentar radiografia adicional em 5% dos pacientes após sete minutos, com esvaziamento completo. Conclusão -A proposta técnica mostrou-se exequível, simples, rápida e eficaz.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Nova opção técnica para colangiografia transoperatória

Silva¹,

Portela²

2011

ABCD, arq. bras. cir. dig.

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“…He stated that cholangiography should be a part of the cholecystectomy procedure. That is to say, he proposed routine perioperative cholangiography and started a controversy that still exists nowadays (1,13) .…”

Section: Introductionmentioning

confidence: 99%

Perioperative fluorocholangiography with routine indication versus selective indication in laparoscopic cholecystectomy

Guerra-Filho

Nunes

Araújo

2007

Arq. Gastroenterol.

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-Background -The use of routine or selective peroperatory cholangiography in cholecystectomy is a matter of controversy in literature. Aim -To compare the efficacy of selective or routine fluorocholangiography in diagnostic of common bile duct stone in patients underwent to laparoscopic cholecystectomy based on selective indication criteria. Method -Two hundred and fifty four patients with cholelithiasis were prospectively studied. The patients were divided in two groups: to the first 127 patients perioperative fluorocholangiography was indicated as routine (group 1), and to the other 127 patients perioperative fluorocholangiography indication followed clinical criteria (jaundice, choluria, fecal acholia and history of pancreatitis), laboratory criteria (increase in seric alkaline phosphatase, bilirubins, amylase) or ultra-sonographyc criteria (less than 6 mm diameter calculi, common bile duct stone, common bile duct diameter more than 6 mm). A comparative assessment of the difference in common bile duct stone diagnosis, fluorocholangiography success index and reliability of the selective criteria of indication for perioperative fluorocholangiography was compared between the two groups. Results -Perioperative fluorocholangiography was successfully performed in 102 of the 127 patients from group 1 (a rate of 80.3%), and in 59 of the 71 patients from group 2 (a rate of 83.1%). In the 102 patients of group 1 who underwent perioperative fluorocholangiography, 11 (10.8%) presented common bile duct stone, 4 (3.9%) presented common bile duct dilatation, and 1 (1%) had a false-positive image. In the 59 patients from group 2, 7 (11.7%) presented common bile duct stone and one (1.7%) presented a common bile duct diatation. In another situation, when application of selective indication criteria to perioperative fluorocholangiography was simulated in group 1 patients, we observed that only in one patient with common bile duct stone the diagnostic would not have been made. Fluorocholangiography selective indication criteria presented sensitivity of 90.9% and specificity of 46.2%. The main causes of fluorocholangiography failure were biliary pedicle inflammation and cystic duct size and caliber variations. Conclusion -There was not a significant difference in common bile duct stone diagnostic through perioperative fluorocholangiography between the groups of patients with selective and routine indication, validating the examination selective indication criteria, with a sensitivity of 90.9%, despite the specificity of 46.2 % -43 patients were selected to the flourocholangiography and common bile duct stone was not diagnosed.

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A colangiografia peroperatória

Cited by 2 publications

References 6 publications

Nova opção técnica para colangiografia transoperatória

Nova opção técnica para colangiografia transoperatória

Perioperative fluorocholangiography with routine indication versus selective indication in laparoscopic cholecystectomy

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