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Clinical Decision Analysis as a Means of Technology Assessment: The Effectiveness of Intraoperative Cholangiography

Published online by Cambridge University Press:  10 March 2009

Thomas E. Scott
Affiliation:
Uniformed Services University of the Health Sciences
Itzhak Jacoby
Affiliation:
Uniformed Services University of the Health Sciences

Abstract

Three strategies for timely detection of common duct stones are examined by decision analysis: the use of intraoperative cholangiography (IOC) in ALL, NONE, or in SOME of the cases that are selected by the estimated probability of a common duct stone. Selective use of IOC is the most cost-effective option and offers a slightly lower mortality risk.

Type
General Essays
Copyright
Copyright © Cambridge University Press 1992

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References

1.Barnes, B. A., & Barnes, A. B.Evaluation of surgical therapy by cost-benefit analysis. Surgery, 1982, 82, 2133.Google Scholar
2.Brolin, R. E., Siemons, G. O., & Fynan, T. M.Critical analysis of retained and residual common duct stones. American Surgeon, 1986, 52, 588–93.Google ScholarPubMed
3.Cranley, B., & Logan, H.Exploration of the common bile duct — The relevance of the clinical picture and the importance of preoperative cholangiography. British Journal of Surgery, 1980, 67, 869–72.CrossRefGoogle Scholar
4.Deitch, E. A., & Voci, V. E.Operative cholangiography The case for selective instead of routine operative cholangiography. American Surgeon, 1982, 48, 297301.Google ScholarPubMed
5.Dellinger, E. P., Kirshenbaum, N., Weinstein, M., & Steer, M.Determinants of adverse reaction following postoperative t-tube cholangiogram. Annals of Surgery, 1980,191, 397403.Google Scholar
6.Doyle, P. J., Ward-McQuaid, J. N., & Smith, A. M.The value of routine postoperative cholangiography — A report of 4000 cholecystectomies. British Journal of Surgery, 1982, 69, 617–19.Google Scholar
7.Eisman, B., & Stahlgren, L.Cost effective surgical management. Philadelphia, PA: W. B. Saunders, 1987.Google Scholar
8.Escallon, A., Rosales, W., & Aldrete, J. S.Reliability of pre- and intraoperative tests for biliary lithiasis. Annals of Surgery, 1985, 201, 640–47.CrossRefGoogle ScholarPubMed
9.Gregg, R. O.The case for selective cholangiography. American Journal of Surgery, 1988, 155, 540–44.CrossRefGoogle ScholarPubMed
10.Hauer-Jensen, M., Karesen, R., Nygaard, K., et al. Predictive ability of choledocholithiasis indicators: A prospective evaluation. Annals of Surgery, 1985, 202, 6468.Google Scholar
11.Jolly, P. C., Baker, J. W., Schmidt, H. M., et al. Operative cholangiography: A case for its routine use. Annals of Surgery, 1968, 168, 551–65.CrossRefGoogle ScholarPubMed
12.Kakos, G. S., Tompkins, R. K., Turnispeed, W., & Zollinger, R. M.Operative cholangiography during routine cholecystectomy. Archives of Surgery, 1972, 104, 484–88.CrossRefGoogle ScholarPubMed
13.Kitahama, A., Kerstein, M. D., Overby, J. L., et al. Routine intraoperative cholangiography. Surgery, Gynecology and Obstetrics, 1986, 162, 317–22.Google Scholar
14.Larson, R. E., Hodgson, J. R., & Priestly, J. T.The early and long term results of 500 consecutive explorations of the common duct. Surgery, Gynecology and Obstetrics, 1966, 123, 744–50.Google Scholar
15.Letton, A. H., & Wilson, J. P.Routine cholangiography during biliary tract operations: Technic and utility in 200 consecutive cases. Annals of Surgery, 1966, 163, 937–42.CrossRefGoogle ScholarPubMed
16.Mofti, A. B., Ahmed, I., Tandon, R. C., et al. Routine or selective peroperative cholangiography? British Journal of Surgery, 1986, 73, 548–50.CrossRefGoogle ScholarPubMed
17.Rolfsmeyer, E. S., Bubrick, M. P., Kollitz, P. R., et al. The value of operative cholangiography. Surgery, Gynecology and Obstetrics, 1982, 154, 369-71.Google ScholarPubMed
18.Sheridan, W. G., Williams, H. O., & Lewis, M. H.Morbidity and mortality of common bile duct exploration. British Journal of Surgery, 1987, 74, 1095-99.Google Scholar
19.Smith, S. W., Engel, C., Averbook, B., et al. Problems of retained and recurrent common bile duct stones. Journal of the American Medical Association, 1957, 164, 231–36.Google Scholar
20.Stark, M. E., & Loughry, C. W.Routine operative cholangiography with cholecystectomy. Surgery, Gynecology and Obstetrics, 1980, 151, 657–58.Google Scholar
21.Wilson, T. G., Hall, J. C., & Watts, J. M.Is operative cholangiography always necessary? British Journal of Surgery, 1986, 73, 637–40.Google Scholar