Is ERCP necessary for symptomatic gallbladder stone patients before laparoscopic cholecystectomy?
Changchien CS; Chuah SK; Chiu KW Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Taiwan, R.O.C. OBJECTIVE: Laparoscopic cholecystectomy (LC) has become the choice of treatment for symptomatic gallbladder stones. The goal of this study was to predict the necessity for ERCP before LC using the noninvasive method of liver function testing (LFT) and sonography. METHODS: Before LC, 115 symptomatic gallbladder stone patients, whose diagnoses were confirmed by sonography, were studied by both LFT and ERCP. Patients who were already found to have either tumors or intrahepatic biliary stones on sonogram were excluded. Patients were classified into normal and dilated biliary tree groups by sonographic findings and normal and abnormal LFT (including bilirubin, alkaline phosphatase, gamma glutamyl transferase and amylase) groups. RESULTS: In patients with both normal biliary sonogram and LFT, 97.6% of patients had a negative ERCP study. Biliary tree dilatio
