Pre-operative MRCP: is it necessary before routine laparoscopic cholecystectomy to exclude CBD stone-prospective study in tertiary care hospital
| Autor: | Reshma Palacharla, Sepuri Bala Ravi Teja, Ganni Bhaskara Rao, Samir Ranjan Nayak |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
business.industry General surgery Tertiary care hospital Pre operative Surgery 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis Medicine 030211 gastroenterology & hepatology business Prospective cohort study Laparoscopic cholecystectomy |
| Zdroj: | International Surgery Journal. 4:3633 |
| ISSN: | 2349-2902 2349-3305 |
| DOI: | 10.18203/2349-2902.isj20174636 |
| Popis: | Background: Cholelithiasis is a common disease and at present the laparoscopic cholecystectomy is the gold standard treatment. The diagnosis of associated common bile duct stone for patients with gallstones is important for prompt surgical decision, treatment efficacy and patient safety. However, whether upper abdominal ultrasound and Liver function test (LFT) is adequate before doing lap cholecystectomy remains controversial. There are different opinions regarding the routine magnetic resonance cholangiopancreatography (MRCP) to detect the possible presence of common bile duct (CBD) stones before laparoscopic cholecystectomy.Methods: This study was carried on a total of 106 patients who were admitted and treated for gall stone diseases in the Department of General Surgery, GSL General Hospital over a period of 24 months. After admission all cases were subjected for liver function test, USG abdomen and MRCP. The collected observational data was analyzed.Results: Among the 106 patients, a total of 17cases showed concurrent gallstones and choledocholithiasis, 11 cases choledocholithiasis were revealed by ultrasound examination, while 6 cases of choledocholithiasis were not detected by ultrasound examination but were confirmed by MRCP.Conclusions: CBD stone may be missed even in the presence of deranged liver enzymes or dilated CBD in USG abdomen. Hence for patient safety routine preoperative MRCP examination is recommended before doing laparoscopic cholecystectomy to rule out the likelihood of concomitant CBD stones. The cost-effectiveness of such expensive investigation is to be studied further taking into consideration preventive costs and patient morbidity and mortality. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|