Selection criteria for preoperative endoscopic retrograde cholangiopancreatography in the laparoscopic era
Robertson GSM., Jagger C., Johnson PRV., Rathbone BJ., Wicks ACB., Lloyd DM., Veitch PS.
Background: Indicators for cholangiography were originally designed to select patients at risk for common bile duct (CBD) stones for intraoperative cholangiography. Objective: To refine these criteria to apply to the much more invasive procedure of preoperative endoscopic retrograde cholangiopancreatography (ERCP). Design: Retrospective review of selection criteria for ERCP in consecutive patients referred over 18 months following the introduction of laparoscopic cholecystectomy. Setting: Two ERCP units in adjacent teaching hospitals. Patients: Three hundred seventeen patients with gallstones and in situ gallbladders. Intervention: Common bile duct imaging at ERCP. Main Outcome Measures: Abnormalities justifying ERCP. Results: Abnormalities justifying ERCP were found in 66% of patients. This group differed significantly from those with normal ducts, with more being referred with abnormal results of all liver function tests (P