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ERCP's Role in the Management of Acute Biliary-pancreatic Pathology in the Laparoscopic Era
OBJECTIVES: Laparoscopic cholecystectomy (LC) combined with endoscopic retrograde cholangiopancreatography (ERCP) has been widely used in the management of the acute biliopancreatic pathology. Nevertheless, controversy remains about the appropriate timing for retrograde cholangiopancreatography. MET...
Autores principales: | , , , , , , , , |
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Formato: | Texto |
Lenguaje: | English |
Publicado: |
Society of Laparoendoscopic Surgeons
2002
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3043444/ https://www.ncbi.nlm.nih.gov/pubmed/12500836 |
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author | del Olmo, J. C. Martín Toledano, M. Blanco, J. I. Cuesta, C. Carbajo, M. Vaquero, C. Inglada, L. Atienza, R. Martín, F. |
author_facet | del Olmo, J. C. Martín Toledano, M. Blanco, J. I. Cuesta, C. Carbajo, M. Vaquero, C. Inglada, L. Atienza, R. Martín, F. |
author_sort | del Olmo, J. C. Martín |
collection | PubMed |
description | OBJECTIVES: Laparoscopic cholecystectomy (LC) combined with endoscopic retrograde cholangiopancreatography (ERCP) has been widely used in the management of the acute biliopancreatic pathology. Nevertheless, controversy remains about the appropriate timing for retrograde cholangiopancreatography. METHODS: A retrospective study was undertaken on a consecutive series of 117 patients with acute biliary-pancreatic pathology, who underwent laparoscopic cholecystectomy between April 1995 and April 1999. Criteria for preoperative endoscopic retrograde cholangiopancreatography were defined, and the patients were divided into 3 groups based on the presence or absence of a preoperative retrograde cholangiopancreatography indication: (1) ERCP+LC group: patients with retrograde cholangiopancreatography indicated and performed (n = 30); (2) LC group: patients without retrograde cholangiopancreatography criteria treated only by LC (n = 47); (3) LC-ERCP group: patients with retrograde cholangiopancreatography criteria but not performed (n = 40). RESULTS: The groups were similar in age, sex, ASA, and clinical diagnosis. No statistical differences occurred in operative times (73.8 min, 68 min, 67 min), major complications (3.3%, 4.25%, 12.5%), and mean postoperative stay (3.7 ± 4; 4.7 ± 2; 5.7 ± 2). Postoperative retrograde cholangiopancreatography had to be used, respectively, in 0%, 10.6%, and 7.5%. The best predictive criteria for common bile duct pathology were choledocholithiasis on an ultrasound scan and the presence of cholangitis. The other criteria tested had a low predictive value. CONCLUSIONS: Preoperative endoscopic retrograde cholangiopancreatography followed by early laparoscopic chole-cystectomy can be performed safely in acute biliary-pancreatic pathology, avoiding 2-stage treatment of these patients and minimizing hospital stay and inconvenience to the patients. Nevertheless, this therapeutic/diagnostic tool must be used selectively. |
format | Text |
id | pubmed-3043444 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2002 |
publisher | Society of Laparoendoscopic Surgeons |
record_format | MEDLINE/PubMed |
spelling | pubmed-30434442011-03-22 ERCP's Role in the Management of Acute Biliary-pancreatic Pathology in the Laparoscopic Era del Olmo, J. C. Martín Toledano, M. Blanco, J. I. Cuesta, C. Carbajo, M. Vaquero, C. Inglada, L. Atienza, R. Martín, F. JSLS Scientific Papers OBJECTIVES: Laparoscopic cholecystectomy (LC) combined with endoscopic retrograde cholangiopancreatography (ERCP) has been widely used in the management of the acute biliopancreatic pathology. Nevertheless, controversy remains about the appropriate timing for retrograde cholangiopancreatography. METHODS: A retrospective study was undertaken on a consecutive series of 117 patients with acute biliary-pancreatic pathology, who underwent laparoscopic cholecystectomy between April 1995 and April 1999. Criteria for preoperative endoscopic retrograde cholangiopancreatography were defined, and the patients were divided into 3 groups based on the presence or absence of a preoperative retrograde cholangiopancreatography indication: (1) ERCP+LC group: patients with retrograde cholangiopancreatography indicated and performed (n = 30); (2) LC group: patients without retrograde cholangiopancreatography criteria treated only by LC (n = 47); (3) LC-ERCP group: patients with retrograde cholangiopancreatography criteria but not performed (n = 40). RESULTS: The groups were similar in age, sex, ASA, and clinical diagnosis. No statistical differences occurred in operative times (73.8 min, 68 min, 67 min), major complications (3.3%, 4.25%, 12.5%), and mean postoperative stay (3.7 ± 4; 4.7 ± 2; 5.7 ± 2). Postoperative retrograde cholangiopancreatography had to be used, respectively, in 0%, 10.6%, and 7.5%. The best predictive criteria for common bile duct pathology were choledocholithiasis on an ultrasound scan and the presence of cholangitis. The other criteria tested had a low predictive value. CONCLUSIONS: Preoperative endoscopic retrograde cholangiopancreatography followed by early laparoscopic chole-cystectomy can be performed safely in acute biliary-pancreatic pathology, avoiding 2-stage treatment of these patients and minimizing hospital stay and inconvenience to the patients. Nevertheless, this therapeutic/diagnostic tool must be used selectively. Society of Laparoendoscopic Surgeons 2002 /pmc/articles/PMC3043444/ /pubmed/12500836 Text en © 2002 by JSLS, Journal of the Society of Laparoendoscopic Surgeons |
spellingShingle | Scientific Papers del Olmo, J. C. Martín Toledano, M. Blanco, J. I. Cuesta, C. Carbajo, M. Vaquero, C. Inglada, L. Atienza, R. Martín, F. ERCP's Role in the Management of Acute Biliary-pancreatic Pathology in the Laparoscopic Era |
title | ERCP's Role in the Management of Acute Biliary-pancreatic Pathology in the Laparoscopic Era |
title_full | ERCP's Role in the Management of Acute Biliary-pancreatic Pathology in the Laparoscopic Era |
title_fullStr | ERCP's Role in the Management of Acute Biliary-pancreatic Pathology in the Laparoscopic Era |
title_full_unstemmed | ERCP's Role in the Management of Acute Biliary-pancreatic Pathology in the Laparoscopic Era |
title_short | ERCP's Role in the Management of Acute Biliary-pancreatic Pathology in the Laparoscopic Era |
title_sort | ercp's role in the management of acute biliary-pancreatic pathology in the laparoscopic era |
topic | Scientific Papers |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3043444/ https://www.ncbi.nlm.nih.gov/pubmed/12500836 |
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