[Criteria for suspected lithiasis of the common bile duct]

Abstract

Although the common bile duct is now accessed using a coelioscopic approach by an increasing number of surgical equipes, the problems related to the diagnostic iter of lithiasis of the common bile duct and the need to obtain a correct preoperative diagnosis, in order to select the most appropriate form of therapy, are of growing topical importance. Following a revision of the literature, the authors focus their attention on those studies which seem to be most interesting and important in relation to the criteria for suspected lithiasis of the common bile duct, studied in single, multivariable and preoperative analyses, namely without taking account of perioperative analyses, namely without taking account of perioperative criteria. These studies reveal the most statistically significant criteria for predicting lithiasis of the common bile duct. Although the application of these studies is not practicable, they undoubtedly arouse considerable interest. The authors have selected the simple criteria whose rigorous application may result in the selection of patients with 0 criteria, with a 1% risk of non-suspected lithiasis of the common bile duct. Perioperative cholangiography (POC) and echoendoscopy are closely correlated to these criteria. The authors outline their diagnostic iter within the framework of a prospective study they carrying out.