Predictive value and main determinants of abnormal features of intraoperative cholangiography during cholecystectomy
| Autor: | Mirhadi Mousavi, Amir Houshang Mohammad Alizadeh, Heshmat Kalbasi, Mohammad Reza Zali, Asad Hashemi, Mahsa Khodadoostan, Shahram Yousefpour Azary, Ali Setayesh |
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| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Gallstones Iran Cholangiography Predictive Value of Tests medicine Humans Cholecystectomy Retrospective Studies Common Bile Duct Analysis of Variance Chi-Square Distribution Intraoperative Care Hepatology medicine.diagnostic_test Common bile duct Bile duct business.industry General surgery Gastroenterology Perioperative Middle Aged medicine.disease Surgery Choledocholithiasis Logistic Models Treatment Outcome medicine.anatomical_structure Predictive value of tests Female business Abdominal surgery |
| Zdroj: | Scopus-Elsevier |
| Popis: | Background The major issue with intraoperative cholangiography (IOC) is whether its diagnostic accuracy for common bile duct (CBD) stones matches that of other diagnostic procedures, and thus, whether it will become a routine diagnostic procedure. The current study aimed to address the main determinants of CBD stone diagnosis in IOC among an Iranian population. Methods In a retrospective review database-based study conducted in Taleghani Hospital in Tehran between 2006 and 2008, baseline data and perioperative information of 2060 patients (male to female ratio 542 : 1518, mean age 53.7 years) who were candidates for cholecystectomy and underwent concomitant IOC for confirming CBD stones were reviewed. The predictive power of this procedure for diagnosis of abnormal biliary ducts with the focus on biliary stones was determined. Results Overall mortality and morbidity following cholecystectomy in the study population were 0.6% and 2.6%, respectively. Both early mortality and morbidity due to cholecystectomy were higher in male than female. The prevalence of CBD stones in IOC was 3.4% (5.2% in male and 2.8% in female, P=0.008). Among those without gallstones, 8.7% had CBD stones and only 3.1% had concomitant gallstones and CBD stones. The main predictors of stone appearance as an abnormal feature of IOC during cholecystectomy were: advanced age (OR=1.022, P=0.001), male gender (OR=1.498, P=0.050), history of abdominal surgery (OR=1.543, P=0.040) and preoperative endoscopie retrograde cholangiopancreatography (OR=5.400, P Conclusions IOC is a safe and accurate method for the assessment of bile duct anatomy and stones. Therefore, the routine use of IOC within cholecystectomy seems reasonable and is recommended. |
| Databáze: | OpenAIRE |
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