Rapid Communication
Copyright ©2007 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 21, 2007; 13(43): 5745-5749
Published online Nov 21, 2007. doi: 10.3748/wjg.v13.i43.5745
Triple non-invasive diagnostic test for exclusion of common bile ducts stones before laparoscopic cholecystectomy
Bahram Pourseidi, Amir Khorram-Manesh
Bahram Pourseidi, Department of Surgery, Kerman University of Medical Science, Kerman, Iran
Amir Khorram-Manesh, Department of Surgery Kungälv and Sahlgrenska University Hospitals, Göteborg, Sweden
Author contributions: All authors contributed equally to the work.
Correspondence to: Amir Khorram-Manesh, MD, PhD, Department of General & Orthopedic Surgery, Kungälv Hospital, S-442 83 KUNGÄLV, Sweden. amir.khorram-manesh@surgery.gu.se
Telephone: +46-303-98008 Fax: +46-303-98326
Received: July 10, 2007
Revised: August 17, 2007
Accepted: October 12, 2007
Published online: November 21, 2007

AIM: To evaluate the impact of a preoperative “triple non-invasive diagnostic test” for diagnosis and/or exclusion of common bile duct stones.

METHODS: All patients with symptomatic gallstone disease, operated on by laparoscopic cholecystectomy from March 2004 to March 2006 were studied retrospectively. Two hundred patients were included and reviewed by using a triple diagnostic test including: patient’s medical history, routine liver function tests and routine ultrasonography. All patients were followed up 2-24 mo after surgery to evaluate the impact of triple diagnostic test.

RESULTS: Twenty-five patients were identified to have common bile duct stones. Lack of history of stones, negative laboratory tests and normal ultrasonography alone was proven to exclude common bile duct stones in some patients. However, a combination of these three components (triple diagnostic), was proven to be the most statistically significant test to exclude common bile duct stones in patients with gallstone disease.

CONCLUSION: Using a combination of routinely used diagnostic components as triple diagnostic modality would increase the diagnostic accuracy of common bile duct stones preoperatively. This triple non-invasive test is recommended for excluding common bile duct stones and to identify patients in need for other investigations.

Keywords: Common bile duct stones, Laparoscopic cholecystectomy, Triple non-invasive diagnostic test