담도 , 췌장 : 총담관결석의 예측 및 복강경 담낭절제술 전 , 후 내시경적 역행성 담췌관조영술의 역할

Background/Aims: Laparoscopic cholecystectomy (LC) can be a choice of treatment for symptomatic gallstones, but has a limitation in treating common bile duct (CBD) stones. This study aimed to evaluate the role of endoscopic retrograde cholangiopancreatography (ERCP) before and after LC relating to prediction of CBD stone. Methods: One hundred seventy-one cases of preoperative ERCP and 16 cases of postoperative ERCP were analyzed. Liver function test, ultrasonographic finding, and gallstone pancreatitis were analyzed as predictive factors for CBD stones. Results: Of 150 patients with successful cannulation, 19 patients had CBD stones. Of 95 patients with abnormal results of liver function test and CBD dilatation, 17 patients had CBD stones. CBD stones were also detected in 23% of patients with elevated aminotransferase, 28% of patients with elevated alkaline phosphatase, 28% of patients with elevated total bilirubin. Five of 23 patients with pancreatitis and sixteen of 38 patients showing the dilatation of bile duct on ultrasonography had also CBD stones. Of 12 patients who needed postoperative ERCP and had abnormal results of liver function test or ultrasonographic finding, 5 had CBD stones. Conclusions: For patients with gallstones who have abnormal results of liver function test and ultrasonographic finding, selective ERCP before and after LC is a useful method for diagnosis and treatment of CBD stones. (Korean J Gastroenterol 2002;39:40-44)