Abstract
The records of 300 consecutive patients who underwent cholecystectomy at a large military teaching hospital from January 1981 through August 1982 were reviewed; 270 patients (90 per cent) had intraoperative cholangiograms. Four clinical indications were helpful in predicting the likelihood of a positive intraoperative cholangiogram: 1, jaundice; 2, pancreatitis, 3, dilated common bile duct, and 4, palpable stones. The 63 patients with at least one of these indications had a 35 per cent indicence of true positive cholangiograms, while the 207 patients without such indications had a 0.5 per cent incidence of true positive studies (p<0.01). The incidence of false-positive studies was 0.7 per cent in our series and 3.1 per cent in our review of the literature of 2,580 cholangiograms. We conclude that cholangiography in the absence of clinical indications has a low yield. If cholangiography had been used selectively during the time period of 20 months of our retrospective study, more than 25,000 dollars could have been saved without missing significant pathologic findings in the common bile duct. We conclude that the thoughtful surgeon should perform cholangiography on a selective rather than routine basis.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 343-345 |
| Number of pages | 3 |
| Journal | Surgery Gynecology and Obstetrics |
| Volume | 161 |
| Issue number | 4 |
| State | Published - 1985 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Obstetrics and Gynecology
- Surgery
Cite this
Routine operative cholangiography. / Mills, Joseph L; Beck, D. E.; Harford, F. J.
In: Surgery Gynecology and Obstetrics, Vol. 161, No. 4, 1985, p. 343-345.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Routine operative cholangiography
AU - Mills, Joseph L
AU - Beck, D. E.
AU - Harford, F. J.
PY - 1985
Y1 - 1985
N2 - The records of 300 consecutive patients who underwent cholecystectomy at a large military teaching hospital from January 1981 through August 1982 were reviewed; 270 patients (90 per cent) had intraoperative cholangiograms. Four clinical indications were helpful in predicting the likelihood of a positive intraoperative cholangiogram: 1, jaundice; 2, pancreatitis, 3, dilated common bile duct, and 4, palpable stones. The 63 patients with at least one of these indications had a 35 per cent indicence of true positive cholangiograms, while the 207 patients without such indications had a 0.5 per cent incidence of true positive studies (p<0.01). The incidence of false-positive studies was 0.7 per cent in our series and 3.1 per cent in our review of the literature of 2,580 cholangiograms. We conclude that cholangiography in the absence of clinical indications has a low yield. If cholangiography had been used selectively during the time period of 20 months of our retrospective study, more than 25,000 dollars could have been saved without missing significant pathologic findings in the common bile duct. We conclude that the thoughtful surgeon should perform cholangiography on a selective rather than routine basis.
AB - The records of 300 consecutive patients who underwent cholecystectomy at a large military teaching hospital from January 1981 through August 1982 were reviewed; 270 patients (90 per cent) had intraoperative cholangiograms. Four clinical indications were helpful in predicting the likelihood of a positive intraoperative cholangiogram: 1, jaundice; 2, pancreatitis, 3, dilated common bile duct, and 4, palpable stones. The 63 patients with at least one of these indications had a 35 per cent indicence of true positive cholangiograms, while the 207 patients without such indications had a 0.5 per cent incidence of true positive studies (p<0.01). The incidence of false-positive studies was 0.7 per cent in our series and 3.1 per cent in our review of the literature of 2,580 cholangiograms. We conclude that cholangiography in the absence of clinical indications has a low yield. If cholangiography had been used selectively during the time period of 20 months of our retrospective study, more than 25,000 dollars could have been saved without missing significant pathologic findings in the common bile duct. We conclude that the thoughtful surgeon should perform cholangiography on a selective rather than routine basis.
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M3 - Article
VL - 161
SP - 343
EP - 345
JO - Journal of the American College of Surgeons
JF - Journal of the American College of Surgeons
SN - 1072-7515
IS - 4
ER -