Avaliação da positividade da colangiografia peroperatória em pacientes submetidos à colecistectomia laparoscópica eletiva

Crema, Eduardo; Camara, Carlos Augusto Canteras Raposo; Pastore, Ricardo; Teles, Celso; Júnior, Júverson Alves Terra; Silva, Alex Augusto

doi:10.1590/s0100-69912010000600005

Cited by 3 publications

(3 citation statements)

References 23 publications

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“…Bruneton [30] notou-se que a USG abdominal apresenta sensibilidade de 77-87% para detecção de dilatação da via biliar. Neste estudo quando comparado a dilatação das vias biliares visualizada ao USG as variáveis dos resultados da CPO e CPRM, a especificidade foi de 81% e 89%; sensibilidade de 52% e 53%; acurácia de 72% e 74% método CPRM, pois trata-se de um método seguro de diagnóstico quando realizado de forma seletiva [31]. Ressalta-se que a dilatação das vias biliares está associada à COD.…”

Section: Discussionunclassified

“…Na literatura, a CPO apresenta algumas desvantagens apontadas: o aumento do tempo cirúrgico (10-17 minutos [32]), aumento dos custos, exposição a equipe médica e paramédica à irradiação ionizante, complicações, como a pancreatite e perfurações, além disso pode resultar em falso-positivo [33] devido a bolhas de ar que imitam cálculos ou a falha no contraste em progredir para o duodeno, podendo resultar em intervenções desnecessárias da árvore biliar, assim como de lesões iatrogênicas advindas dessa manipulação [9,31,34,39]. Segundo Crema [31] a CPO deve ser dispensada para avaliação da presença de COD, para que seja evitado possíveis complicações aos ductos biliares advindos do uso desse método invasivo.…”

Section: Discussionunclassified

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Análise Da Presença De Coledocolitíase, Através Da Ressonância Magnética Nuclear E Colangiografia Peroperatório

Lenza,

Ruas,

da Silva

et al. 2023

rsc

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O objetivo deste estudo foi analisar a presença de coledocolitíase, através da ressonância magnética e colangiografia peroperatória. Trata-se de estudo de coorte e retrospectivo, no qual foram avaliados 120 pacientes com diagnóstico de colelitíase e suspeita de coledocolitíase. Observou-se que nos exames de imagens os diagnósticos foram de colelitíase, coledocolitíase, dilatação das vias biliares, colelitíase mais coledocolitíase, colelitíase mais dilatação das vias biliares, colecistite e pancreatite. Na presença de colangiopancreatografia por ressonância positiva para coledocolítiase havia um risco de 105 vezes maior, respectivamente, de colangiografia peroperatória positiva para coledocolitíase no mesmo paciente. Na presença de coledocolitíase à ultrassonografia abdominal havia risco nove vezes maior de colangiografia peroperatória positiva para coledocolitíase. E na colangiografia peroperatória positiva para coledocolitíase havia um risco de 104 vezes maior de colangiopancreatografia por ressonância positiva para coledocolitíase no mesmo paciente e na presença de coledocolitíase ao ultrassom abdominal havia risco seis vezes maior. A colangiopancreatografia por ressonância magnética para diagnóstico tem boa concordância para o diagnóstico de coledocolitíase quando comparado com a colangiografia peroperatória

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Section: Discussionunclassified

Análise Da Presença De Coledocolitíase, Através Da Ressonância Magnética Nuclear E Colangiografia Peroperatório

Lenza,

Ruas,

da Silva

et al. 2023

rsc

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“…MRCP, a non-invasive method of bile duct imaging, has a sensitivity described between 85-92% and specificity of 93-97% for choledocholithiasis 17 . When used to exclude the presence of choledocholithiasis, it may exclude CPO in order to avoid possible injuries to the bile ducts resulting from the use of this invasive method, in addition to shortening the operative time 4 .…”

Section: Discussionmentioning

confidence: 99%

Comparative Evaluation of Magnetic Resonance Cholangiopancreatography and Perioperative Cholangiography in Patients With Suspect Choledocholithiasis

Perales¹,

Souza²,

Crema³

2019

ABCD, arq. bras. cir. dig.

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Background:Cholelithiasis is a highly prevalent condition, and choledocholitiasis is a high morbidity complication and requires accurate methods for its diagnosis. Aim:To evaluate the population of patients with suspected choledocholitiasis and check the statistical value of magnetic resonance cholangiopancreatography, ultrasonography, the laboratory and the clinic of these patients comparing them to the results obtained by perioperative cholangiography. Methods:This is a retrospective cohort study, which were evaluated 76 patients with cholelithiasis and suspected choledocholithiasis. Results:It was observed that the presence of dilatation of the biliary tract or choledocholithiasis in the ultrasonography was four and eight times increased risk of perioperative cholangiography for positive choledocholithiasis, respectively. For each unit increased in serum alkaline phosphatase was 0.3% increased the risk of perioperative cholangiography for positive choledocholithiasis. In the presence of dilatation of the bile ducts in the ultrasonography was four times greater risk of positive magnetic resonance cholangiopancreatography for choledocholithiasis. In the presence of pancreatitis these patients had five times higher risk of positive magnetic resonance cholangiopancreatography for choledocholithiasis. On the positive magnetic resonance cholangiopancreatography presence to choledocholithiasis was 104 times greater of positive perioperative cholangiography for choledocholithiasis. Conclusions:The magnetic resonance cholangiopancreatography is a method with good accuracy for propedeutic follow-up for the diagnosis of choledocholithiasis, consistent with the results obtained from the perioperative cholangiography; however, it is less invasive, with less risk to the patient and promote decreased surgical time when compared with perioperative cholangiography.

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Unsuspected choledocholithiasis found by routine intra‐operative cholangiography during laparoscopic cholecystectomy

O’Neill

Wennmacker

Bhimani

et al. 2020

ANZ Journal of Surgery

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Background: The true incidence of unsuspected choledocholithiasis found during laparoscopic cholecystectomy (LC) is unknown. Untreated 'silent' stones may be associated with significant long-term risks. The aim of this study was to establish the incidence of unsuspected common bile duct stones (CBDS) and to determine the management and associated risk factors for unsuspected CBDS. Methods: Retrospective review of a large consecutive series of patients from Australia who underwent LC in a tertiary referral setting. Percentages of unsuspected CBDS, management and complications were reported. Pre-operative and intra-operative factors associated with unsuspected CBDS were determined using multivariable logistic regression analysis. Results: From a total of 1998 patients who underwent LC, 747 (37.4%) patients with no pre-operative suspicious factors were the subject of this study. CBDS were detected in 24 (3.2%) patients and all were managed either laparoscopically or endoscopically. Risk factors independently associated with unsuspected CBDS included patients >55 years of age (odds ratio 2.93, P = 0.038) and a large cystic duct size (odds ratio = 3.13, P < 0.001) on multivariable analysis. Conclusion: The incidence of patients with unsuspected CBDS on intra-operative cholangiography is low. Complete clearance of these stones can be achieved using a combination of laparoscopic and endoscopic methods.

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Avaliação da positividade da colangiografia peroperatória em pacientes submetidos à colecistectomia laparoscópica eletiva

Cited by 3 publications

References 23 publications

Análise Da Presença De Coledocolitíase, Através Da Ressonância Magnética Nuclear E Colangiografia Peroperatório

Análise Da Presença De Coledocolitíase, Através Da Ressonância Magnética Nuclear E Colangiografia Peroperatório

Comparative Evaluation of Magnetic Resonance Cholangiopancreatography and Perioperative Cholangiography in Patients With Suspect Choledocholithiasis

Unsuspected choledocholithiasis found by routine intra‐operative cholangiography during laparoscopic cholecystectomy

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