Dwerryhouse S J, Brown E, Vipond M N
Department of Surgery, Gloucestershire Royal Hospital, Gloucester, UK.
Br J Surg. 1998 Oct;85(10):1364-6. doi: 10.1046/j.1365-2168.1998.00957.x.
BACKGROUND: With the advent of laparoscopic cholecystectomy, endoscopic retrograde cholangiography (ERC) is frequently employed before operation to detect common bile duct stones. However, this is an invasive technique with recognized complications. This study evaluated the accuracy of magnetic resonance cholangiography (MRC) to detect choledocholithiasis in selected patients before laparoscopic cholecystectomy. METHODS: Patients scheduled for elective laparoscopic cholecystectomy, with risk factors for common bile duct stones, underwent MRC followed by ERC or peroperative cholangiography. RESULTS: Over a 2-year period 40 patients were studied. MRC had a sensitivity of 88 per cent, specificity of 93 per cent, positive predictive value of 78 per cent and negative predictive value of 97 per cent for the detection of common bile duct stones. CONCLUSION: MRC is a simple non-invasive method for preoperative screening for common bile duct stones in at-risk patients. In this study it would have reduced the need for ERC by three-quarters.
背景:随着腹腔镜胆囊切除术的出现,术前常采用内镜逆行胆管造影(ERC)来检测胆总管结石。然而,这是一种有公认并发症的侵入性技术。本研究评估了磁共振胆管造影(MRC)在选定患者行腹腔镜胆囊切除术之前检测胆总管结石的准确性。 方法:计划行择期腹腔镜胆囊切除术且有胆总管结石危险因素的患者,先接受MRC检查,随后接受ERC或术中胆管造影。 结果:在2年期间对40例患者进行了研究。MRC检测胆总管结石的灵敏度为88%,特异度为93%,阳性预测值为78%,阴性预测值为97%。 结论:MRC是一种简单的非侵入性方法,用于对有风险患者进行术前胆总管结石筛查。在本研究中,它可将ERC的需求减少四分之三。
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