Symptoms of Common Duct Stones

Strohl, E. Lee

doi:10.1001/archsurg.1952.01260010808010

AMA Arch Surg

1952

DOI: 10.1001/archsurg.1952.01260010808010

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Symptoms of Common Duct Stones

E. Lee Strohl¹

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1959

1988

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Cited by 15 publications

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Prediction of choledocholithiasis using a pocket microcomputer

Taylor

Armstrong

Rimmer

et al. 1988

Journal of British Surgery

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A computerized method, using a small pocket computer, has been used to predict the presence of choledocholithiasis in a prospective series of 239 patients undergoing cholecystectomy. From an initial data base of 424 patients 36 factors were evaluated and the most important 2 of these were determined by multivariate analysis for use in the prospective analysis. Satisfactory operative cholangiograms were a prerequisite to evaluation of the statistical method and were obtained in 90.4 per cent of cases. Using the computerized method a common bile duct stone would have been overlooked in only 1 patient but 17 unnecessary explorations would have been carried out. The overall accuracy of the computerized method was 92.5 per cent. When the method was applied to a further study of 97 patients from a separate centre the overall accuracy was 85.6 per cent. If the method was used to aid selective use of operative cholangiography, cholangiograms would be performed in 20 per cent and stones would be overlooked in less than 1 per cent.

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Prediction of choledocholithiasis using a pocket microcomputer

Taylor

Armstrong

Rimmer

et al. 1988

Journal of British Surgery

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Prospective study of clinical and biochemical features of symptomatic choledocholithiasis

et al. 1986

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One hundred consecutive patients were prospectively studied to assess the clinical and biochemical features of symptomatic choledocholithiasis. Biochemical tests were performed during the three days following the onset of symptoms. Pain was the most frequent symptom of choledocholithiasis, observed in 75% of the patients, but rarely occurred alone (12%). Clinical symptoms were not different according to age. High serum gamma glutamyl transpeptidase and alkaline phosphatase were the most frequent biochemical abnormalities in patients with symptomatic choledocholithiasis: they were increased in 94 and 91% of cases, respectively. Only one patient had no biochemical abnormality. Serum transaminases could reach very high levels just as in hepatitis. Biochemical data did not differ regardless of whether the common bile duct was enlarged or not. Biochemical abnormalities had been studied over the first 10 days of spontaneous evolution in 25 patients while choledocholithiasis persisted: serum bilirubin and transaminases significantly decreased while serum gamma glutamyl transpeptidase, alkaline phosphatase, and amylase remained unchanged. These results indicate that, in patients with suggestive symptoms, choledocholithiasis is unlikely in the absence of biochemical abnormalities in the first three days following the onset of symptoms.

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An evaluation of the indications for exploration of the common duct

Smith

Wilhelm

1959

The American Journal of Surgery

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Symptoms of Common Duct Stones

Cited by 15 publications

References 10 publications

Prediction of choledocholithiasis using a pocket microcomputer

Prediction of choledocholithiasis using a pocket microcomputer

Prospective study of clinical and biochemical features of symptomatic choledocholithiasis

An evaluation of the indications for exploration of the common duct

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