caa a22 4500 475779959 CHVBK 20180406123641.0 cr unu---uuuuu 170329e20000301xx s 000 0 eng 10.1007/s004640000049 doi (NATIONALLICENCE)springer-10.1007/s004640000049 Preoperative abdominal ultrasound may be misleading in risk stratification for presence of common bile duct abnormalities [Elektronische Daten] [R. A. Lichtenbaum, H. F. McMullen, R. M. Newman] Background: Following the advent of laparoscopic cholecystectomy (LC), the preoperative predictors of common bile duct (CBD) abnormalities became more important in perioperative decision making. Preoperative transabdominal ultrasound (US) is used to assess the preoperative risks associated with CBD abnormalities. This study attempts to determine the sensitivity and specificity of US in determining CBD abnormalities in patients prior to LC. Methods: US measurements of the CBD diameter and presence of stones were ascertained from radiology reports in 100 patients who had LC with a routine intraoperative cholangiogram (IOC). The same information was obtained from the patients' IOC. A supraduodenal CBD diameter of >8 mm was considered dilated. Results: US demonstrated a sensitivity of 25% and a specificity of 70% for the detection of CBD dilatation compared to IOC. The sensitivity of US for predicting CBD dilatation was 55% when the IOC-derived diameter was >10 mm and 100% when it was >15 mm. The overall sensitivity of US for detection of stones was 10%; it improved to 17% in patients with a dilated CBD on US. Conclusions: Preoperative ultrasound is neither sensitive nor specific for detecting CBD dilatation or presence of stones. A negative preoperative US report may be misleading in risk stratification for the presence of these CBD abnormalities. In order to avoid missing any CBD pathology, we recommend the routine use of intraoperative cholangiography. Springer-Verlag New York Inc., 2000 Key words: Cholecystectomy — Common bile duct stones — Gallbladder — Intraoperative cholangiography — Laparoscopy — Ultrasonography nationallicence Lichtenbaum R. A. Department of Surgery, Bellevue Hospital Center, New York University School of Medicine, 27th Street and First Avenue, New York, NY 10016, USA, USA aut McMullen H. F. Department of Surgery, Bellevue Hospital Center, New York University School of Medicine, 27th Street and First Avenue, New York, NY 10016, USA, USA aut Newman R. M. Department of Surgery, Bellevue Hospital Center, New York University School of Medicine, 27th Street and First Avenue, New York, NY 10016, USA, USA aut Surgical Endoscopy Springer-Verlag 14/3(2000-03-01), 254-257 0930-2794 14:3<254 2000 14 464 https://doi.org/10.1007/s004640000049 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004640000049 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Lichtenbaum R. A. Department of Surgery, Bellevue Hospital Center, New York University School of Medicine, 27th Street and First Avenue, New York, NY 10016, USA, USA aut NATIONALLICENCE 700 1- McMullen H. F. Department of Surgery, Bellevue Hospital Center, New York University School of Medicine, 27th Street and First Avenue, New York, NY 10016, USA, USA aut NATIONALLICENCE 700 1- Newman R. M. Department of Surgery, Bellevue Hospital Center, New York University School of Medicine, 27th Street and First Avenue, New York, NY 10016, USA, USA aut NATIONALLICENCE 773 0- Surgical Endoscopy Springer-Verlag 14/3(2000-03-01), 254-257 0930-2794 14:3<254 2000 14 464 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer