Authors: Per Videhult Gabriel Sandblom Ib Christian Rasmussen
Publish Date: 2008/04/09
Volume: 23, Issue: 2, Pages: 304-312
Abstract
Although intraoperative cholangiography IOC is a widely used method for detecting common bile duct stones CBDS its accuracy has not been fully evaluated in large nonselected patient samples The purpose of this study was to assess the sensitivity specificity and predictive value of dynamic IOC regarding its ability to diagnose CBDS in a populationbased setting and to assess the morbidity associated with the investigationAll patients operated on for gallstone disease between 2003 and 2005 in the county of Uppsala in Sweden a county with a population of 302000 in December 2004 were registered prospectively The outcome of cholangiography was validated against the postoperative clinical course1171 patients were registered and among these IOC was performed in 1117 patients 95 Common bile duct stones were found in 134 patients 11 One perforation of the common bile duct caused by the IOC catheter was recorded Sensitivity was 97 specificity 99 negative predictive value 99 positive predictive value 95 and overall accuracy 99 In 7 of the 134 cases where IOC indicated CBDS no stones could be verified on exploration In 4 of the 979 cases where IOC was normal the clinical course indicated overlooked CBDS
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