Faculty Collaboration Database

Routine preoperative laboratory analyses are unnecessary before elective laparoscopic cholecystectomy. Surg Endosc 2003 Mar;17(3):438-41

Date

11/19/2002

Pubmed ID

12436231

DOI

10.1007/s00464-002-8540-4

Scopus ID

2-s2.0-0344406678 (requires institutional sign-in at Scopus site)   11 Citations

Abstract

BACKGROUND: We formulated a clinical pathway (CP) for elective laparoscopic cholecystectomy (LC), which included the following preoperative evaluation: history and physical (H&P), right upper quadrant ultrasound (US), and liver function tests (LFTs). We hypothesized that routine LFTs did not alter management beyond that dictated by H&P and US, and could be excluded from the CP.

METHODS: The study involved 387 consecutive patients undergoing elective LC. Abnormalities in the preoperative evaluation were compared with the finding of choledocholithiasis or other unexpected outcomes.

RESULTS: In 187 (48%) patients, abnormalities were found by H&P (n = 7), US (n = 13), and LFTs (n = 177). Seven patients (2%) had documented choledocholithiasis; two had abnormal H & P; three had abnormal US; and four had abnormal LFTs. No patient with choledocholithiasis had abnormal LFTs but normal H&P and US.

CONCLUSIONS: Routine LFTs before elective LC are not cost effective. Before LC H&P and US are warranted, but LFTs do not add any useful information and should not be routinely measured.

Author List

Robinson TN, Biffl WL, Moore EE, Heimbach JK, Calkins CM, Burch J

Author

Casey Matthew Calkins MD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Cholangiopancreatography, Endoscopic Retrograde
Cholecystectomy, Laparoscopic
Cholelithiasis
Clinical Protocols
Diagnostic Tests, Routine
Elective Surgical Procedures
Female
Humans
Liver Function Tests
Male
Prospective Studies
Unnecessary Procedures