Preoperative MRCP Can Rule Out Choledocholithiasis in Acute Cholecystitis with a High Negative Predictive Value: Prospective Cohort Study with Intraoperative Cholangiography

Mattila, Anne; Helminen, Olli; Pynnönen, Emilia; Sironen, Antti; Elomaa, Eeva; Nevalainen, Mika

doi:10.1007/s11605-023-05790-x

Journal of Gastrointestinal Surgery

2023

DOI: 10.1007/s11605-023-05790-x

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Preoperative MRCP Can Rule Out Choledocholithiasis in Acute Cholecystitis with a High Negative Predictive Value: Prospective Cohort Study with Intraoperative Cholangiography

Anne Mattila

Olli Helminen

Emilia Pynnönen³

et al.

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2024

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Cited by 2 publications

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Comparison of 1-stage and 2-stage Managements for Common Bile Duct Stones and Gallstones (CBDS)

Zhou,

Chen,

et al. 2024

Journal of Clinical Gastroenterology

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Objective: The aim of this study was to evaluate the efficacy, safety, and surgical outcomes of 2-stage management, namely preoperative endoscopic retrograde cholangiopancreatography (ERCP) + laparoscopic cholecystectomy (ERCP+LC) or LC + postoperative ERCP (LC+ERCP), as well as 1-stage management, LC + laparoscopic common bile duct exploration (LCBDE) for treating patients with gallstones and common bile duct stones (CBDS). Methods: This retrospective study analyzed the data of 180 patients with common bile duct stones (CBDS) who were admitted to the Department of General Surgery at Tongji Hospital, Tongji University, between January 2019 and June 2021. The study included 3 groups: ERCP+LC (group 1), LC+ERCP (group 2), and LC+LCBDE (group 3), each consisting of 60 patients. Clinical metrics of the patients were collected and compared among the groups. Results: Group 3 had the shortest operation duration and hospital stay compared with group 1 and group 2. In addition, group 3 had the lowest long-term postoperative complications, particularly the recurrence rate of CBDS. The total cost was also the lowest in group 3. Furthermore, patients in group 3 had the lowest postoperative amylase levels. All patients in the study achieved successful stone clearance. There were no significant differences in the conversion to other procedures rate, postoperative alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin, and mortality among the three groups (P > 0.05). Conclusions: Both 1-stage management and 2-stage management are effective treatments for CBDS. The LC+LCBDE management is a safe treatment option, offering shorter hospital stays and operation duration, lower costs, and fewer complications.

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Comparison of 1-stage and 2-stage Managements for Common Bile Duct Stones and Gallstones (CBDS)

Zhou,

Chen,

et al. 2024

Journal of Clinical Gastroenterology

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Duplicate gallbladders misdiagnosed as residual cholecystitis: A case report and review of the literature

Ma,

Feng,

et al. 2024

Medicine

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Rationale: Duplication of gallbladder is a rare anomaly in humans, as it is very rare for a duplication of gallbladder to be missed during the first cholecystectomy and thus require a second cholecystectomy. Patient concerns: A 42-year-old man came to our hospital with paroxysmal right upper abdominal pain for 10 days. In addition to the pain, he also had transient jaundice. He had undergone laparoscopic cholecystectomy (LC) 1 year ago. Magnetic resonance cholangiopancreatography showed gallstones, intrahepatic bile duct stones with cholangitis, no dilatation of the common bile duct, and a cystic structure was visible in the upper part of common bile duct. The patient underwent LC again, and the intraoperative diagnosis was duplication of gallbladder. Diagnosis: The patient was diagnosed with duplication of gallbladder during surgery. Interventions: The patient underwent LC again. Outcomes: The patient underwent LC again, and was diagnosed with duplicated gallbladder during the operation. The operation was successful and the patient was discharged on the 5th day after the operation without other complications. Lessons: Our case and literature review showed that there are no specific signs of duplicated gallbladders, and ultrasound has a low sensitivity for the diagnosis of double gallbladders, so double gallbladders are easily missed. Patients with double gallbladders may have multiple missed diagnoses during diagnosis and treatment, as in this case. When patients experience upper abdominal pain again after gallbladder removal, we should be alert and consider the possibility of duplicated gallbladders.

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Preoperative MRCP Can Rule Out Choledocholithiasis in Acute Cholecystitis with a High Negative Predictive Value: Prospective Cohort Study with Intraoperative Cholangiography

Cited by 2 publications

References 20 publications

Comparison of 1-stage and 2-stage Managements for Common Bile Duct Stones and Gallstones (CBDS)

Comparison of 1-stage and 2-stage Managements for Common Bile Duct Stones and Gallstones (CBDS)

Duplicate gallbladders misdiagnosed as residual cholecystitis: A case report and review of the literature

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