Hauer-Jensen M, Kåresen R, Nygaard K, Solheim K, Amlie E, Havig O, Viddal K O
Ann Surg. 1985 Jul;202(1):64-8. doi: 10.1097/00000658-198507000-00010.
To assess the predictive ability of various indicators of common bile duct calculi, 457 patients undergoing cholecystectomy for gallstone disease were prospectively screened for the presence of 11 predefined criteria of possible choledocholithiasis. The predictive ability of the criteria, individually and in combinations, was determined. For all criteria, except a history of pancreatitis, a significantly increased incidence of choledocholithiasis was found. The number of positive criteria correlated positively with the frequency of common bile duct calculi. The negative predictive value and sensitivity of the total set of criteria were 98% and 89.5%, respectively. Following common duct exploration, the number of complications and the duration of postoperative hospitalization were significantly increased as compared with simple cholecystectomy. Peroperative cholangiography with cholecystectomy is recommended in all patients, with one or more criteria of possible choledocholithiasis. Routine peroperative cholangiography in patients with no positive criteria does not seem to be necessary.
为评估胆总管结石各种指标的预测能力，对457例因胆结石疾病行胆囊切除术的患者进行前瞻性筛查，以确定是否存在11项预先定义的可能胆总管结石标准。确定了这些标准单独及联合使用时的预测能力。除胰腺炎病史外，所有标准下胆总管结石的发病率均显著增加。阳性标准的数量与胆总管结石的发生率呈正相关。所有标准的阴性预测值和敏感性分别为98%和89.5%。与单纯胆囊切除术相比，胆总管探查术后并发症的数量和术后住院时间显著增加。建议对所有有一项或多项可能胆总管结石标准的患者在胆囊切除术中进行术中胆管造影。对于没有阳性标准的患者，常规术中胆管造影似乎没有必要。
