English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Plus monthly

Global: Zendy Tools annual

Global: Zendy Tools monthly

Global: Zendy Free Plan

OPC is widely utilized routinely, as well as temporary drainage of the explored ducts is the most com mon approach to such ducts, assuming that choledochal calculi migrate from the GB, until proved other wise. These are, nonetheless, questionable issues. Aiming to define their exact usefulness the Author review ed his experience, retrospectively (1973-79, OPC routine) and prospectively (1980-82, OPC selective) with primary surgery for lithogenic disease: 308 Cholecystectomies, 85 of which (27,5 Vo) underwent CBDE. From these, 14 were temporarily drained and 71 definitively decompressed, either abolishing or bypassing the S.0. Two patients died, for an overall mortality rate of 0,64 %. One case (0,3 %) of an unsuspected stone and two anomalies (0,6 %), only detectable by OPC, were picked Out by this method. There were no iatrogenic injuries. Over 64 % of duct stones were stasis calculi. The costs were 20 % higher when OPC was routine. The long term POOR results (patients requiring resurgery) were significantly higher among the ducts temporarily drained as opposed to those not meeting the exploration criteria (5/14 or 36% versus ~/222 or 1,8%, p=O,00l) and to those explored and definitively decompressed (36% versus 0/70 or 0%, p = 0,001). It is suggested that the key problem is a motility disorder of the S.O. (achalasic dysfunction?), the duct stones being a consequence of it, not the pathology itself. The poor cost-effectiveness of routine OPC does not justify it, at least when experienced surgeons are involved. Likewise a permanent decom pression of most ducts requiring exploration seems to offer the best long term prognosis.

Operative cholangiography cost-effectiveness--routine versus selective utilization.