The Correlation Analysis Between Serum ?-GT And Common Bile Duct Stone With Negative Result Of MRCP

Background: Clinical often in the traditional common bile duct exploration indications(common bile duct diameter,imaging,blood amylase,etc.)to decide on laparoscopic gallbladder excision of biliary tract probe into whether surgery at the same time.In recent years because of MRCP in bravery manager of high sensitivity,specificity,make it become the important basis of evaluation of common bile duct calculi.MRCP,however,there are still some false negative,and therefore we assessed the biochemical indexes of simple and noninvasive,as a basis for the evaluation of patients with common bile duct calculi occur,can reduce missed diagnosis,the fault diagnosis rate,for common bile duct exploration in the art of complement.Methods:We are retrospectively analyzed in our hospital from 2014 to 2015 line general surgery,Laparoscopic cholecystectomy,Laparoscopic cholecystectomy)+bile duct exploration(the common bile duct exploration),a total of 514 cases,preoperative conventional assessed the six biochemical indicators: glutamine transpeptidase,cholinesterase,total bilirubin,direct bilirubin,alanine aminotransferase and aspertate aminotransferase.In contrast,we also included MRCP,B ultrasonic,the result of the common bile duct diameter,blood amylase.For evaluating bravery manager potential diagnostic examination,all of the above objective results are closely into and compared carefully.Results:Routine intraoperative bile duct exploration in 514 patients,329 cases of patients with common bile duct calculi diagnosed the ridgeway parallel undercholedochoscope choledochoscope top take nephrolithotomy;185 patients intraoperative choledochoscope detection did not see bravery manager.Of all the diagnostic test results,the accuracy of MRCP highest(80.4%),sensitivity(74.5%),specificity(90.8%).The sensitivity of ultrasound was highest(92.2%),specificity(37.2%)and accuracy(70.1%).Combined with the specificity of the bilirubin was highest(93%),sensitivity(27.1%)and accuracy(50.8%).A number of Logistics regression suggests the highest correlation with common bile duct calculi was followed by MRCP,common bile duct diameter and GGT.In MRCP negative correlation between the highest is in turn: common bile duct diameter,GGT,TB.Conclusion: Laparoscopic transcystic common bile duct exploration has a high success rate,short postoperative hospital stays,low cost of hospitalization and complication rate in treating cholecystolithiasis and choledocholithiasis.It has good application value.