Management of Suspected Choledocholithiasis: A Decision Analysis for Choosing the Optimal Imaging Modality

Sonnenberg, Amnon; Enestvedt, Brintha K.; Bakis, Gennadiy

doi:10.1007/s10620-015-3882-7

Cited by 16 publications

(12 citation statements)

References 15 publications

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“…CT MRCP preferred prior to a cholecystectomy, which may then be combined with intraoperative cholangiography and transcystic stone removal. [42][43][44][45][46][47][48][49][50] Patients with a normal US or MRCP, with a suspicion of CL should be evaluated further if the clinical and laboratory findings are not within normal boundaries.…”

Section: Usmentioning

confidence: 99%

Accuracy of Imaging Modalities in Choledocholithiasis: A Real-Life Data

Orman¹,

Şenateş

Ulasoglu

et al. 2018

International Surgery

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In this retrospective study of real-life data, we aimed to determine the diagnostic accuracy in patients with choledocholithiasis of some current imaging modalities, including ultrasonography (US), computerized tomography (CT), magnetic resonance cholangiopancreatography (MRCP), and endoscopic retrograde cholangiopancreatography (ERCP). This study utilized a database of imaging records from 86 consecutive patients with ERCP-proven choledocholithiasis in a single-center outpatient clinic. Features of the stones found, namely number, size, localization, choledochal dilation and cholestasis, were determined using various imaging modalities and liver function tests (LFTs). Our study focused on a total of 86 patients (43 female; 43 male) who underwent the ERCP procedure. Hepatobiliary ultrasound was performed in 71 (82.6%); MRCP in 59 (68.6%); and CT in 13 (15.1%) patients. All 86 patients had choledocholithiasis: 59 (68.6%) with multiple stones and 21 (24.4%) with stones over 10 mm in diameter. Sensitivity for the presence of choledocholithiasis was 40.8% for US, 76.9% for CT, and 86.4% for MRCP, where ERCP was taken as the reference method. Even though US, CT, and MRCP are widely used as noninvasive imaging modalities for CL, in our real-life data their sensitivity for choledocholithiasis was lower than expected. MRCP is preferred when a nontherapeutic but only diagnostic evaluation is aimed for; however, while highly competent in establishing the level of choledochal dilation, it had a low yield in differentiating the localization, size, and number of the stone(s).

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Section: Usmentioning

confidence: 99%

Accuracy of Imaging Modalities in Choledocholithiasis: A Real-Life Data

Orman¹,

Şenateş

Ulasoglu

et al. 2018

International Surgery

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“…Our study included patients with acute cholecystitis that needs to be treated with biliary intervention which may increase the length of stay, whereas previous study included only patients underwent cholecystectomy. Diagnostic accuracy of MRCP for detecting CBD stones has been clearly demonstrated and is comparable to that of ERCP and intraoperative cholangiography; in addition, the sensitivity and specificity are greater than 90% [22][23][24]. Detection and elimination of CBD stones before operation is important because residual CBD stones can induce postoperative complication such as early biliary leakage, jaundice, cholangitis, and pancreatitis [25].…”

Section: Discussionmentioning

confidence: 99%

“…Diagnostic accuracy of MRCP for detecting CBD stones has been clearly demonstrated and is comparable to that of ERCP and intraoperative cholangiography; in addition, the sensitivity and specificity are greater than 90% [ 22 23 24 ]. Detection and elimination of CBD stones before operation is important because residual CBD stones can induce postoperative complication such as early biliary leakage, jaundice, cholangitis, and pancreatitis [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Impacts on outcomes and management of preoperative magnetic resonance cholangiopancreatography in patients scheduled for laparoscopic cholecystectomy: for whom it should be considered?

et al. 2020

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Cholecystectomy is currently considered the main therapy choice for patients with benign gallbladder disease, although there are no international guidelines on patient selection. This procedure is performed frequently, with more than 800 ,000 cholecystectomies annually in the United States, and associated major global health burden [1,2]. Development of diagnostic imaging modalities such as CT, MRI, and ultrasonography and their widespread application

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“…С развитием неинвазивного и высокоинформативного дооперационного обследования -МР-холангиографии и эндосонографии диагноз холедохолитиаза и отбор больных для двухэтапного лечения значительно упростились [14][15][16][17][18].…”

Section: х олецистохоледохолитиаз -форма желчнокаменной болезни хараunclassified

Surgical Management of Choledocholithiasis

Тотиков¹,

Shulutko²,

Тобоев³

et al. 2020

Medical news of the North Caucasus

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2 первый московский государственный медицинский университет им. И. м. Сеченова (Сеченовский Университет), Российская Федерация 3 Городская больница, Кисловодск, Российская Федерация 4 Ставропольский государственный медицинский университет, Российская Федерация 5 Республиканский онкологический диспансер, Республика Северная Осетия-Алания, Владикавказ, Российская Федерация surgical managemenT of choledocholiThiasis Totikov V. Z. 1 , shulutko a. m. 2 , Toboev d. V. 5 , Totikov Z. V. 1 , natroshvili a. g. 2 , natroshvili i. g. 3 , Baychorov e. h. 4 , moiseev a. Yu. 2 , Voitkovskii a. e. 4 1 north-ossetian state medical academy, Vladikavkaz, russian federation 2 i. m. sechenov first moscow state medical university (sechenov university), russian federation 3 municipal hospital, Kislovodsk, russian federation 4 stavropol state medical university, russian federation 5 republican oncological dispensary, republic of north ossetia-alania, Vladikavkaz, russian federation Для анализа результатов одно-и двухэтапного методов хирургического лечения холецистохоледохолитиаза проведено ретроспективное исследование 1076 больных, оперированных в плановом порядке в хирургических клиниках Владикавказа, Москвы и Кисловодска с 1997 по 2014 год. Успешная санация общего желчного протока достигнута у 98 % пациентов, общее число осложнений составило 8,0 %, послеоперационная летальность-0,28 %. При достаточном опыте хирургов современные малоинвазивные технологии позволяют надежно и безопасно использовать одномоментную тактику хирургического лечения холецистохоледохолитиаза. Статистически достоверной разницы в эффективности и безопасности одно-и двухэтапного алгоритмов хирургического лечения холецистохоледохолитиаза настоящее исследование не выявило. Ключевые слова: холедохолитиаз, желчнокаменная болезнь, лапароскопическая холедохолитотомия To evaluate the results of single and two-stage management of choledocholithiasis we performed retrospective analysis of 1076 patients undergone surgery in hospitals of Vladikavkaz, Moscow and Kislovodsk in 1997-2014. Successful debridement of the common bile duct was achieved in 98 % of patients, the total number of complications was 8.0 %, postoperative mortality was 0.28 %. Experienced surgeon can use single-stage algorithm safely and effectively. The present study did not reveal a statistically significant difference in the efficacy and safety of single-and two-stage management of cholecystocholedocholithiasis.

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Management of Suspected Choledocholithiasis: A Decision Analysis for Choosing the Optimal Imaging Modality

Abstract: MRC, EUS, and ERCP should be used in sequence and dependent on the pre-test probability of choledocholithiasis.

Cited by 16 publications

References 15 publications

Accuracy of Imaging Modalities in Choledocholithiasis: A Real-Life Data

Accuracy of Imaging Modalities in Choledocholithiasis: A Real-Life Data

Impacts on outcomes and management of preoperative magnetic resonance cholangiopancreatography in patients scheduled for laparoscopic cholecystectomy: for whom it should be considered?

Surgical Management of Choledocholithiasis

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