담낭절제술시 경담낭관 조영술의 의의

• Published in: The Korean journal of gastroenterology Vol. 26; no. 6; pp. 952 - 961
• Main Authors: 이명복, Myung Bog Lee, 이민혁, Min Hyuk Lee, 허경열, Kyung Yul Hur, 송영식, Young Sik Song, 허경발, Kyung Bal Hur
• Format: Journal Article
• Language: Korean
• Published: 대한소화기학회 01.01.1994
• Subjects: Cholecystectomy; Gallstone; Operative cystic duct cholangiography(OCDC)
• ISSN: 1598-9992

The routine use of operative cystic duct cholangiography(OCDC) has been advocated by nu- merous authors. In these studies, the value of OCDC in the detection of unsuspected small stones of the common bile duct was demonstrated. The procedure also appears to be of value in reducing unnecessary exploration of the common bile duct in patients otherwise having clin- ical indications for such exploration. But opinion is divided as to whether cholangiography should be performed in all cholecystectomies or only in selected cases. To determine the clinical usefulness of routine OCDC, we analyzed 307 patients undergoing cholecystectomy with routine OCDC for gallstone disease were retrospectively screened for the presence of 8 parameters of possible choledocholithiasis. Of the 307 patients studied, 241 pa- tients(78.5%) had a negative OCDC(group I ), 22(7.1%) had false positive findings (group II), two(0.7%) had false negative findings(group III), and 42(13.7%) had findings positive for stones(group IV). In group I, 81 pat.ients(33.6%) had one or more parameter of possible choledocholithiasis. In group II, 16 patients(72.7% ) had one or more parameter. In group III, 2 patients(100%) had one or more parameter. In group IV, 5 patients(11.9%) without any positive parameter had choledocholithiasis. The sensitivity of OCDC was 95.5%, specificity 91. 4%, efficiency 92.2%, predictability of a negative test 99.2%, predictability of a positive test 65.5%, and accuracy 92.8%. Routine OCDC showed unsuspected common bile duct stones in 5 patients(2.9%). Unnecessary common bile duct explorations were avoided in 81 of the 136 pa- tients(59.5%). As a result of these findings, we recommend the use of OCDC routinely in pa- tients undergoing cholecystectomy. (Korean J Gastroenterol 1994; 26: 952 961)