DETECTION OF CBD STONES IN PATIENTS WITH LITHIASIS OF THE GALLBLADDER.

Abstract

Before the laparoscopic era, detection of CBD stones in patients with lithiais of the gallbladder has been made, preferably, by intraoperative cholangiography. Development of laparoscopy gives the necessity of a preoperative detection of CBD stones, expecially when a previous endoscopic treatment is preferred. T enon ’s multifactorial score, in the Author’s opinion, is able to detect patients “at risk” for CBD stones. This score includes the following parameters: age, CBD diameter, size of gallstones, colic pain and cholecystitis.

The chance of CBD stones was 2 % for a score lower than 3,5 and 81 % for a score greater than 5,9. In this way, patients with high probability of CBD stones can be submitted to a preoperative ERCP or to a intraoperative cholangiography, according to the choices of the surgeon.