Initial Cholecystectomy vs Sequential Common Duct Endoscopic Assessment and Subsequent Cholecystectomy for Suspected Gallstone Migration

• Autores: Pouya Iranmanesh, Jean Louis Frossard, Béatrice Mugnier Konrad, Philippe Morel
• Localización: JAMA: the journal of the American Medical Association, ISSN 0098-7484, Vol. 312, Nº. 2, 2014, págs. 137-144
• Idioma: inglés
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• Resumen

  • Importance The optimal management of treatment for patients at intermediate risk of a common duct stone (including increased liver function tests but bilirubin <4 mg/dL and no cholangitis) is a matter of debate. Many stones migrate spontaneously into the duodenum, making preoperative common duct investigations unnecessary.

    Objective To compare strategies of cholecystectomy first vs a sequential endoscopic common duct assessment and cholecystectomy for the management of patients with an intermediate risk of a common duct stone. The main objective was to reduce the length of stay and the secondary objectives were to reduce the number of common duct investigations, morbidity, and costs.