This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Role of biliary scintiscan in predicting the need for cholangiography. BJS 2000; 87: 181-185.
Published: 10th December 2002
Authors: S. K. Mathur, Z. F. Soonawalla, S. R. Shah, M. Goel, S. Shikare
Background
Currently used predictors for bile duct calculi in patients undergoing cholecystectomy have low specificity resulting in unnecessary cholangiograms being performed. The role of biliary scintiscan in predicting the presence of bile duct calculi was assessed.
Method
Seventy‐five patients with symptomatic gallstone disease were studied prospectively regarding the value of a history of jaundice or acute pancreatitis, raised serum bilirubin and serum alkaline phosphatase levels, and visualization of stones or presence of dilated bile ducts on ultrasonography (standard criteria) in detecting bile duct calculi. Results of biliary scintiscan were evaluated against a combination of standard criteria. The ‘gold standard’ for evaluation was endoscopic or peroperative cholangiography.
Results
Biliary scintiscan had a higher sensitivity and specificity (93 and 94 per cent) than a combination of the above standard and modified predictors for biliary calculi (89 and 71 per cent). A combination of ultrasonography and selective use of scintiscan, in the absence of bile duct dilatation only, had higher values (96 and 98 per cent).
Conclusion
A combination of ultrasonography and biliary scintiscan can accurately predict bile duct calculi and could be used as a guide for selective cholangiography. © 2000 British Journal of Surgery Society Ltd
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