Cost effectiveness of intraoperative laparoscopic ultrasound for suspected choledocholithiasis; outcomes from a specialist benign upper gastrointestinal unit.

Annals of the Royal College of Surgeons of England
S DonoghueS Andrews

Abstract

Common bile duct stones are present in 10% of patients with symptomatic gallstones. One-third of UK patients undergoing cholecystectomy will have preoperative ductal imaging, commonly with magnetic resonance cholangiopancreatography. Intraoperative laparoscopic ultrasound is a valid alternative but is not widely used. The primary aim of this study was to assess cost effectiveness of laparoscopic ultrasound compared with magnetic resonance cholangiopancreatography. A prospective database of all patients undergoing laparoscopic cholecystectomy between 2015 and 2018 at a district general hospital was assessed. Inclusion criteria were all patients, emergency and elective, with symptomatic gallstones and suspicion of common bile duct stones (derangement of liver function tests with or without dilated common bile duct on preoperative ultrasound, or history of pancreatitis). Patients with known common bile duct stones (magnetic resonance cholangiopancreatography or failed endoscopic retrograde cholangiogram) were excluded. Ninety-day morbidity data were also collected. A total of 420 (334 elective and 86 emergency) patients were suspected to have common bile duct stones and were included in the study. The cost of a laparoscopic ultras...Continue Reading

References

Nov 1, 1989·Archives of Surgery·A OríaB Frider
Sep 25, 2001·The American Journal of Gastroenterology·K MenonP M Bret
Nov 24, 2004·Gastrointestinal Endoscopy·Merete ChristensenJacob Rosenberg
Jan 29, 2010·Gastrointestinal Endoscopy·John T MapleJason A Dominitz
Nov 2, 2014·BMJ : British Medical Journal·Sheryl WarttigUNKNOWN Guideline Development Group

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