Ultrasound versus liver function tests for diagnosis of common bile duct stones

Gurusamy, Kurinchi Selvan; Giljača, Vanja; Takwoingi, Yemisi; Higgie, David; Poropat, Goran; Štimac, Davor; Davidson, Brian R

doi:10.1002/14651858.cd011548

Cited by 94 publications

(86 citation statements)

References 128 publications

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“…False-positive results are also possible and further noninvasive testing is recommended to confirm common bile duct stones to avoid the risks of invasive testing. 3,4 Deranged LFT and jaundice is found in 6 cases out of 15 cases harboring the Common bile duct stone. Raised LFT and clinical jaundice were not significantly different in patients with chronic, acute or complicated cholecystitis and high-risk patients should undergo further imaging to exclude choledocholitiasis.…”

Section: Discussionmentioning

confidence: 99%

“…Raised LFT and clinical jaundice were not significantly different in patients with chronic, acute or complicated cholecystitis and high-risk patients should undergo further imaging to exclude choledocholitiasis. [3][4][5] In all our cases we proceeded for MRCP. Dilated CBD / dilated CBD with stone found in 11 out of 17 suspected case of CBD pathology.…”

Section: Discussionmentioning

confidence: 99%

“…3 Elevated level of liver enzymes did not have major role in CBD diagnosis and even with normal ultrasonography findings. 4 A large number of studies have indicated that the accuracy of ultrasound diagnosis of choledocholithiasis is not high. When liver enzymes are elevated in the biochemical tests choledocholithiasis cannot be ruled out even if the ultrasound result is normal.…”

Section: Introductionmentioning

confidence: 99%

“…As a result, the diagnosis of choledocholithiasis by ultrasound and other conventional methods is not particularly reliable. 4,5 Endoscopic retrograde cholangiopancreatography (ERCP) has the highest accuracy in diagnosis of CBD stone. But this approach is invasive, needs expertise, and also expensive.…”

Section: Introductionmentioning

confidence: 99%

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Pre-operative MRCP: is it necessary before routine laparoscopic cholecystectomy to exclude CBD stone-prospective study in tertiary care hospital

et al. 2017

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Pre-operative MRCP: is it necessary before routine laparoscopic cholecystectomy to exclude CBD stone-prospective study in tertiary care hospital

et al. 2017

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“…Because US had 73% of pooled sensitivity in a meta-analysis of 5 studies [20] and CT had 65-93% of sensitivity, those radiologic tests are not recommended for the investigation of CBD stones [21][22][23] . By contrast, MRC had median 93% of sensitivity from 13 studies [24] and EUS is a new, less invasive imaging technique with good sensitivity (95%) and specificity (98%) for the detection of CBD stones, as shown by previous studies [19,25,26] .…”

Section: Discussionmentioning

confidence: 99%

The Efficacy of Clinical Predictors for Patients with Intermediate Risk of Choledocholithiasis

et al. 2016

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Background/Aims: For the suspected choledocholithiasis, the American Society for Gastrointestinal Endoscopy has proposed guidelines to assign risk based on clinical predictors. The study aimed to assess the usefulness of clinical predictors of choledocholithiasis set forth by the guidelines in patients with intermediate risk of choledocholithiasis. Methods: In 2014, 109 patients with intermediate risk of choledocholithiasis underwent endoscopic ultrasound. Their medical records were retrospectively reviewed. The gold standard for choledocholithiasis was endoscopic retrograde cholangiopancreatography or clinical follow-up. Results: Based on endoscopic ultrasound findings, choledocholithiasis was suspected in 18 patients, and it was removed in 17 patients. Choledocholithiasis was absent in the remaining 91 who did not show any signs from endoscopic ultrasound. Among the 2 strong (common bile duct (CBD) diameter >6 mm and bilirubin 1.8-4 mg/dl) and 3 moderate (abnormal liver biochemical test other than bilirubin, age >55 years and gallstone pancreatitis) clinical predictors, 28.8% of patients with one of the strong predictors had choledocholithiasis; however, only 3.5% of patients with any one of the moderate predictors had choledocholithiasis. As a result, only strong clinical predictors showed predictability: increased bilirubin level (OR 3.23; 90% CI 0.85-12.28) and dilated CBD diameter (OR 5.83; 90% CI 1.93-17.57). Conclusion: Only strong clinical predictors of choledocholithiasis showed predictability for patients with intermediate risk of choledocholithiasis.

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Endoscopic retrograde cholangiopancreatography versus intraoperative cholangiography for diagnosis of common bile duct stones

Gurusamy

Giljača

Takwoingi

et al. 2015

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Ultrasound versus liver function tests for diagnosis of common bile duct stones

Cited by 94 publications

References 128 publications

Pre-operative MRCP: is it necessary before routine laparoscopic cholecystectomy to exclude CBD stone-prospective study in tertiary care hospital

Pre-operative MRCP: is it necessary before routine laparoscopic cholecystectomy to exclude CBD stone-prospective study in tertiary care hospital

The Efficacy of Clinical Predictors for Patients with Intermediate Risk of Choledocholithiasis

Endoscopic retrograde cholangiopancreatography versus intraoperative cholangiography for diagnosis of common bile duct stones

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