[Common bile duct stones. Diagnostic and therapeutic management].

Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
S Förster, E Klar

Abstract

The best predictors for the presence of common bile duct stones (CBDS) are cholangitis, jaundice, and direct visualization of stones with ultrasound. In the setting of high suspicion of choledocholithiasis, endoscopic retrograde cholangiography (ERC) is indicated because when CBDS are identified, it allows immediate therapy in the same sitting. If there is a moderate probability of choledocholithiasis, endosonography or magnetic resonance cholangiopancreatography are the first-line options. In patients with gallbladder stones and CBDS, preoperative ERC with or without endoscopic sphincterotomy (ES) is widely recommended as a standard approach. The interval between that and laparoscopic cholecystectomy (LC) should be at least 24 h (<6 weeks) to exclude possible complications due to the ERC/ES. In the setting of open cholecystectomy, open bile duct surgery is significantly superior to ERC with sphincterotomy in achieving common bile duct clearance and is the method of choice. Only in centres with advanced laparoscopic expertise is the laparoscopic removal of CBDS an equivalent treatment option.

References

Oct 1, 1996·Gastrointestinal Endoscopy·P A AbboudS V Williams
Jul 26, 2002·Journal of Hepato-biliary-pancreatic Surgery·Hiromi TokumuraKyoji Yamamoto
Jan 31, 2004·Surgical Endoscopy·S EbnerG Szinicz
Apr 22, 2005·The American Journal of Gastroenterology·Jong Ho MoonBoo Sung Kim
Jun 16, 2005·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·John GriniatsosAlberto M Isla
Aug 30, 2005·Journal of the American College of Surgeons·Edward H Livingston, Robert V Rege
Sep 3, 2005·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Seyed Amir MirbagheriReza Malekzadeh
Apr 21, 2006·The Cochrane Database of Systematic Reviews·D J MartinJ Toouli
Jul 25, 2006·Gastrointestinal Endoscopy·Dharmendra VermaDouglas G Adler
Oct 21, 2006·The Cochrane Database of Systematic Reviews·B M WeinbergS Lo
Sep 18, 2007·Zeitschrift für Gastroenterologie·F LammertUNKNOWN Deutschen Gesellschaft für Viszeralchirurgie zur Diagnostik und Behandlung von Gallensteinen

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Citations

Mar 13, 2010·Annals of the Royal College of Surgeons of England·James HorwoodRichard Morgan

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