Retrospective study of negative predictive value of liver function test and ultrasonography for common bile duct stone after cholecystectomy at Maesot Hospital
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Abstract
Background: Ultrasonography and Liver Function Test (LFT) are used for diagnosis of symptomatic gall stone. Both are basic tools used in all hospitals with low cost and no requirement of specialists. They are also used as a guide for further diagnosis of common bile duct stone. However, a question raised is if the integrated use of ultrasonography and Liver Function Test is still valued and efficient as a predictive tool of common bile duct stone after cholecystectomy.
Objective: To conduct retrospective study of negative predictive value of liver function test and ultrasonography for common bile duct stone after cholecystectomy at Maesot Hospital.
Materials and methods : A retrospective study was conducted among patients, diagnosed with symptomatic gall stone, who underwent for cholecystectomy at Maesot Hospital between January 2013 and December 2018. Preoperative ultrasonography and liver function test were record. Follow-up for common bile duct stone was conducted by clinical personnel more than two years. General data was analyzed by descriptive statistics and negative predictive values of ultrasonography and liver function test for common bile duct stone after cholecystectomy were calculated.
Results: There were 442 patients with the mean age of 50.6 years (range 17.5-89.7). Three hundred and twenty three cases were female (73.07%). There were 54 cases diagnosed by computer tomography and 388 cases by ultrasonography. 60 cases were those without preoperative Liver Function Test. 364 cases were normal liver function test. Abnormal liver function test were found in 18 cases with prior diagnosis, all of these were found to be normal before the operation date. 217 cases were done by open cholecystectomy and 218 cases by laparoscopic cholecystectomy, 7cases were converted to open cholecystectomy. Less than two-month follow-up was conducted with 126 cases; follow-up (2 months-2 years) with 188 cases; follow-up (> 2 years) with 128 cases. Common bile duct stone was found in three cases. All of them reported their results of ultrasonography and only gall stones were found. However, no bile duct dilatation was detected and liver function test revealed normal status.
Conclusion: Negative predictive value of liver function test and ultrasonography for common bile duct stone was very high at 99.22%. Only 0.78% had common bile duct stone and their symptoms could be managed by endoscopic retrograde cholangiopancraticography. Normal Liver Function Test and ultrasonography indicate a low risk of commom bile duct stone and no further evaluations are recommended and cholecystectomy can be done.
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References
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