[The diagnostic and therapeutic unity of endoscopic retrograde cholangiopancreatography in patients with a diagnosis of choledocholithiasis and its complications].

Abstract

Reviewing the records of 60 patients admitted with clinical diagnosis of common duct stone, we demonstrated that the symptoms and the biochemical liver tests were predictive of choledocholithiasis only 50% of the time. The sensitivity for the ultrasound was 42%. The ERCP diagnosed pancreatic or biliary pathology in over 90% of the patients. Through endoscopic sphincterotomy, the ERCP prevented the surgical exploration of the common bile duct in 93% of the patients, and did not aggravate the clinical picture in the group with acute pancreatitis. The sequence of ERCP--laparoscopic cholecystectomy decreased the hospital days and has emerged as the treatment of choice for the patients with cholelithiasis and suspected common duct stone.