Loading…
Utilizing CT to identify clinically significant biliary dilatation in symptomatic post-cholecystectomy patients: when should we be worried?
Purpose To determine a reliable threshold common duct diameter on CT, in combination with other ancillary CT and clinical parameters, at which the likelihood of pathology requiring further imaging or intervention is increased in post-cholecystectomy patients. Methods In this IRB approved retrospecti...
Saved in:
| Published in: | Abdominal imaging 2022-12, Vol.47 (12), p.4126-4138 |
|---|---|
| Main Authors: | , , , , , , , , , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Citations: | Items that this one cites Items that cite this one |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| cited_by | cdi_FETCH-LOGICAL-c305t-7acb8fc2742ec044794f80aba64bb35dfecd3eae219af24328709315cf7198553 |
|---|---|
| cites | cdi_FETCH-LOGICAL-c305t-7acb8fc2742ec044794f80aba64bb35dfecd3eae219af24328709315cf7198553 |
| container_end_page | 4138 |
| container_issue | 12 |
| container_start_page | 4126 |
| container_title | Abdominal imaging |
| container_volume | 47 |
| creator | Uko, Imo I. Wood, Cecil Nguyen, Edward Huang, Annie Catania, Roberta Borhani, Amir A. Horowitz, Jeanne M. Gabriel, Helena Keswani, Rajesh Nikolaidis, Paul Miller, Frank H. Kelahan, Linda C. |
| description | Purpose
To determine a reliable threshold common duct diameter on CT, in combination with other ancillary CT and clinical parameters, at which the likelihood of pathology requiring further imaging or intervention is increased in post-cholecystectomy patients.
Methods
In this IRB approved retrospective study, two attending radiologists independently reviewed CT imaging for 118 post-cholecystectomy patients, who were subsequently evaluated with MRCP, ERCP, or EUS, prompted by findings on the CT and clinical status. Measurements of the common duct (CD) were obtained at the porta hepatis, distal duct, and point of maximal dilation on axial and coronal CT scans. Patients were grouped by whether they required intervention after follow-up imaging. Pertinent baseline lab values and patient demographics were reviewed.
Results
Of the 118 post-cholecystectomy patients, 38 patients (31%) required intervention, and 80 patients (69%) did not require intervention after follow-up imaging. For both readers, axial and coronal CD diameters were significantly higher in the ‘intervention required’ vs ‘no intervention’ groups at all locations (
p
value 10 mm on CT and elevated bilirubin levels should undergo further clinical and imaging follow-up.
Graphical abstract |
| doi_str_mv | 10.1007/s00261-022-03660-9 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2714653482</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2730896495</sourcerecordid><originalsourceid>FETCH-LOGICAL-c305t-7acb8fc2742ec044794f80aba64bb35dfecd3eae219af24328709315cf7198553</originalsourceid><addsrcrecordid>eNp9kctu1TAQhiMEolXbF2CBLLFhExjbcS5sEDqigFSpm3ZtOY59jivHDrGjo_QdeAeehSfrtKdc1AUrz3i--ceevyheUXhHAZr3CYDVtATGSuB1DWX3rDhmGJUAon3-T3xUnKV0AwC0FpQy8bI44jWFqmrZcfHjOjvvbl3Yks0VyZG4wYTs7Prrp_YuOK28xzi5bXAWs5BJjw1qXsngvMoquxiICySt45TjiLkmU0y51LvojV5TNhrvVzJhCaXTB7LfGeR3cfED2RvSG7KP8-zM8PG0eGGVT-bs8Twprs8_X22-lheXX75tPl2UmoPIZaN031rNmooZjR9pusq2oHpVV33PxWCNHrhRhtFOWVZx1jbQcSq0bWjXCsFPircH3WmO3xeTshxd0sZ7FUxckmQNrWrBcUOIvnmC3sRlDvg6pDi0XV1194LsQOk5pjQbK6fZjbglSUHe-yUPfkn0Sz74JTtsev0ovfSjGf60_HYHAX4AEpbC1sx_Z_9H9g5_BKSZ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2730896495</pqid></control><display><type>article</type><title>Utilizing CT to identify clinically significant biliary dilatation in symptomatic post-cholecystectomy patients: when should we be worried?</title><source>Springer Nature</source><creator>Uko, Imo I. ; Wood, Cecil ; Nguyen, Edward ; Huang, Annie ; Catania, Roberta ; Borhani, Amir A. ; Horowitz, Jeanne M. ; Gabriel, Helena ; Keswani, Rajesh ; Nikolaidis, Paul ; Miller, Frank H. ; Kelahan, Linda C.</creator><creatorcontrib>Uko, Imo I. ; Wood, Cecil ; Nguyen, Edward ; Huang, Annie ; Catania, Roberta ; Borhani, Amir A. ; Horowitz, Jeanne M. ; Gabriel, Helena ; Keswani, Rajesh ; Nikolaidis, Paul ; Miller, Frank H. ; Kelahan, Linda C.</creatorcontrib><description>Purpose
To determine a reliable threshold common duct diameter on CT, in combination with other ancillary CT and clinical parameters, at which the likelihood of pathology requiring further imaging or intervention is increased in post-cholecystectomy patients.
Methods
In this IRB approved retrospective study, two attending radiologists independently reviewed CT imaging for 118 post-cholecystectomy patients, who were subsequently evaluated with MRCP, ERCP, or EUS, prompted by findings on the CT and clinical status. Measurements of the common duct (CD) were obtained at the porta hepatis, distal duct, and point of maximal dilation on axial and coronal CT scans. Patients were grouped by whether they required intervention after follow-up imaging. Pertinent baseline lab values and patient demographics were reviewed.
Results
Of the 118 post-cholecystectomy patients, 38 patients (31%) required intervention, and 80 patients (69%) did not require intervention after follow-up imaging. For both readers, axial and coronal CD diameters were significantly higher in the ‘intervention required’ vs ‘no intervention’ groups at all locations (
p
value < 0.05). There was good to excellent inter-reader agreement at all locations (ICC 0.68–0.92). Pertinent baseline lab values including AST (
p
= 0.043), ALT (
p
= 0.001), alkaline phosphatase (
p
= 0.0001), direct bilirubin (
p
= 0.011), total bilirubin (
p
= 0.028), and WBC (
p
= 0.043) were significantly higher in the ‘intervention required’ group. CD thresholds of 8 mm yielded the highest sensitivities (76–95%), and CD thresholds of 12 mm yielded the highest specificities (65–78%). CD combined with bilirubin levels increased sensitivity and specificity, compared to using either feature alone.
Conclusion
Dilated CD on CT combined with bilirubin levels increases the sensitivity and specificity for identifying patients needing intervention. We recommend that a post-cholecystectomy patient who presents with a CD diameter > 10 mm on CT and elevated bilirubin levels should undergo further clinical and imaging follow-up.
Graphical abstract</description><identifier>ISSN: 2366-0058</identifier><identifier>ISSN: 2366-004X</identifier><identifier>EISSN: 2366-0058</identifier><identifier>DOI: 10.1007/s00261-022-03660-9</identifier><identifier>PMID: 36104482</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdomen ; Alkaline phosphatase ; Bilirubin ; Cholecystectomy ; Computed tomography ; Diameters ; Dilatation ; Dilatation, Pathologic ; Gastroenterology ; Hepatobiliary ; Hepatology ; Humans ; Imaging ; Intervention ; Medical imaging ; Medicine ; Medicine & Public Health ; Patients ; Radiology ; Retrospective Studies ; Sensitivity ; Thresholds ; Tomography, X-Ray Computed</subject><ispartof>Abdominal imaging, 2022-12, Vol.47 (12), p.4126-4138</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022. Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c305t-7acb8fc2742ec044794f80aba64bb35dfecd3eae219af24328709315cf7198553</citedby><cites>FETCH-LOGICAL-c305t-7acb8fc2742ec044794f80aba64bb35dfecd3eae219af24328709315cf7198553</cites><orcidid>0000-0003-2011-8084</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36104482$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Uko, Imo I.</creatorcontrib><creatorcontrib>Wood, Cecil</creatorcontrib><creatorcontrib>Nguyen, Edward</creatorcontrib><creatorcontrib>Huang, Annie</creatorcontrib><creatorcontrib>Catania, Roberta</creatorcontrib><creatorcontrib>Borhani, Amir A.</creatorcontrib><creatorcontrib>Horowitz, Jeanne M.</creatorcontrib><creatorcontrib>Gabriel, Helena</creatorcontrib><creatorcontrib>Keswani, Rajesh</creatorcontrib><creatorcontrib>Nikolaidis, Paul</creatorcontrib><creatorcontrib>Miller, Frank H.</creatorcontrib><creatorcontrib>Kelahan, Linda C.</creatorcontrib><title>Utilizing CT to identify clinically significant biliary dilatation in symptomatic post-cholecystectomy patients: when should we be worried?</title><title>Abdominal imaging</title><addtitle>Abdom Radiol</addtitle><addtitle>Abdom Radiol (NY)</addtitle><description>Purpose
To determine a reliable threshold common duct diameter on CT, in combination with other ancillary CT and clinical parameters, at which the likelihood of pathology requiring further imaging or intervention is increased in post-cholecystectomy patients.
Methods
In this IRB approved retrospective study, two attending radiologists independently reviewed CT imaging for 118 post-cholecystectomy patients, who were subsequently evaluated with MRCP, ERCP, or EUS, prompted by findings on the CT and clinical status. Measurements of the common duct (CD) were obtained at the porta hepatis, distal duct, and point of maximal dilation on axial and coronal CT scans. Patients were grouped by whether they required intervention after follow-up imaging. Pertinent baseline lab values and patient demographics were reviewed.
Results
Of the 118 post-cholecystectomy patients, 38 patients (31%) required intervention, and 80 patients (69%) did not require intervention after follow-up imaging. For both readers, axial and coronal CD diameters were significantly higher in the ‘intervention required’ vs ‘no intervention’ groups at all locations (
p
value < 0.05). There was good to excellent inter-reader agreement at all locations (ICC 0.68–0.92). Pertinent baseline lab values including AST (
p
= 0.043), ALT (
p
= 0.001), alkaline phosphatase (
p
= 0.0001), direct bilirubin (
p
= 0.011), total bilirubin (
p
= 0.028), and WBC (
p
= 0.043) were significantly higher in the ‘intervention required’ group. CD thresholds of 8 mm yielded the highest sensitivities (76–95%), and CD thresholds of 12 mm yielded the highest specificities (65–78%). CD combined with bilirubin levels increased sensitivity and specificity, compared to using either feature alone.
Conclusion
Dilated CD on CT combined with bilirubin levels increases the sensitivity and specificity for identifying patients needing intervention. We recommend that a post-cholecystectomy patient who presents with a CD diameter > 10 mm on CT and elevated bilirubin levels should undergo further clinical and imaging follow-up.
Graphical abstract</description><subject>Abdomen</subject><subject>Alkaline phosphatase</subject><subject>Bilirubin</subject><subject>Cholecystectomy</subject><subject>Computed tomography</subject><subject>Diameters</subject><subject>Dilatation</subject><subject>Dilatation, Pathologic</subject><subject>Gastroenterology</subject><subject>Hepatobiliary</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Imaging</subject><subject>Intervention</subject><subject>Medical imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Patients</subject><subject>Radiology</subject><subject>Retrospective Studies</subject><subject>Sensitivity</subject><subject>Thresholds</subject><subject>Tomography, X-Ray Computed</subject><issn>2366-0058</issn><issn>2366-004X</issn><issn>2366-0058</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><recordid>eNp9kctu1TAQhiMEolXbF2CBLLFhExjbcS5sEDqigFSpm3ZtOY59jivHDrGjo_QdeAeehSfrtKdc1AUrz3i--ceevyheUXhHAZr3CYDVtATGSuB1DWX3rDhmGJUAon3-T3xUnKV0AwC0FpQy8bI44jWFqmrZcfHjOjvvbl3Yks0VyZG4wYTs7Prrp_YuOK28xzi5bXAWs5BJjw1qXsngvMoquxiICySt45TjiLkmU0y51LvojV5TNhrvVzJhCaXTB7LfGeR3cfED2RvSG7KP8-zM8PG0eGGVT-bs8Twprs8_X22-lheXX75tPl2UmoPIZaN031rNmooZjR9pusq2oHpVV33PxWCNHrhRhtFOWVZx1jbQcSq0bWjXCsFPircH3WmO3xeTshxd0sZ7FUxckmQNrWrBcUOIvnmC3sRlDvg6pDi0XV1194LsQOk5pjQbK6fZjbglSUHe-yUPfkn0Sz74JTtsev0ovfSjGf60_HYHAX4AEpbC1sx_Z_9H9g5_BKSZ</recordid><startdate>20221201</startdate><enddate>20221201</enddate><creator>Uko, Imo I.</creator><creator>Wood, Cecil</creator><creator>Nguyen, Edward</creator><creator>Huang, Annie</creator><creator>Catania, Roberta</creator><creator>Borhani, Amir A.</creator><creator>Horowitz, Jeanne M.</creator><creator>Gabriel, Helena</creator><creator>Keswani, Rajesh</creator><creator>Nikolaidis, Paul</creator><creator>Miller, Frank H.</creator><creator>Kelahan, Linda C.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>JQ2</scope><scope>K7-</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-2011-8084</orcidid></search><sort><creationdate>20221201</creationdate><title>Utilizing CT to identify clinically significant biliary dilatation in symptomatic post-cholecystectomy patients: when should we be worried?</title><author>Uko, Imo I. ; Wood, Cecil ; Nguyen, Edward ; Huang, Annie ; Catania, Roberta ; Borhani, Amir A. ; Horowitz, Jeanne M. ; Gabriel, Helena ; Keswani, Rajesh ; Nikolaidis, Paul ; Miller, Frank H. ; Kelahan, Linda C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c305t-7acb8fc2742ec044794f80aba64bb35dfecd3eae219af24328709315cf7198553</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Abdomen</topic><topic>Alkaline phosphatase</topic><topic>Bilirubin</topic><topic>Cholecystectomy</topic><topic>Computed tomography</topic><topic>Diameters</topic><topic>Dilatation</topic><topic>Dilatation, Pathologic</topic><topic>Gastroenterology</topic><topic>Hepatobiliary</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Imaging</topic><topic>Intervention</topic><topic>Medical imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Patients</topic><topic>Radiology</topic><topic>Retrospective Studies</topic><topic>Sensitivity</topic><topic>Thresholds</topic><topic>Tomography, X-Ray Computed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Uko, Imo I.</creatorcontrib><creatorcontrib>Wood, Cecil</creatorcontrib><creatorcontrib>Nguyen, Edward</creatorcontrib><creatorcontrib>Huang, Annie</creatorcontrib><creatorcontrib>Catania, Roberta</creatorcontrib><creatorcontrib>Borhani, Amir A.</creatorcontrib><creatorcontrib>Horowitz, Jeanne M.</creatorcontrib><creatorcontrib>Gabriel, Helena</creatorcontrib><creatorcontrib>Keswani, Rajesh</creatorcontrib><creatorcontrib>Nikolaidis, Paul</creatorcontrib><creatorcontrib>Miller, Frank H.</creatorcontrib><creatorcontrib>Kelahan, Linda C.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>ProQuest_Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Computer Science Collection</collection><collection>Computer science database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest Biological Science Journals</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest advanced technologies & aerospace journals</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Abdominal imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Uko, Imo I.</au><au>Wood, Cecil</au><au>Nguyen, Edward</au><au>Huang, Annie</au><au>Catania, Roberta</au><au>Borhani, Amir A.</au><au>Horowitz, Jeanne M.</au><au>Gabriel, Helena</au><au>Keswani, Rajesh</au><au>Nikolaidis, Paul</au><au>Miller, Frank H.</au><au>Kelahan, Linda C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Utilizing CT to identify clinically significant biliary dilatation in symptomatic post-cholecystectomy patients: when should we be worried?</atitle><jtitle>Abdominal imaging</jtitle><stitle>Abdom Radiol</stitle><addtitle>Abdom Radiol (NY)</addtitle><date>2022-12-01</date><risdate>2022</risdate><volume>47</volume><issue>12</issue><spage>4126</spage><epage>4138</epage><pages>4126-4138</pages><issn>2366-0058</issn><issn>2366-004X</issn><eissn>2366-0058</eissn><abstract>Purpose
To determine a reliable threshold common duct diameter on CT, in combination with other ancillary CT and clinical parameters, at which the likelihood of pathology requiring further imaging or intervention is increased in post-cholecystectomy patients.
Methods
In this IRB approved retrospective study, two attending radiologists independently reviewed CT imaging for 118 post-cholecystectomy patients, who were subsequently evaluated with MRCP, ERCP, or EUS, prompted by findings on the CT and clinical status. Measurements of the common duct (CD) were obtained at the porta hepatis, distal duct, and point of maximal dilation on axial and coronal CT scans. Patients were grouped by whether they required intervention after follow-up imaging. Pertinent baseline lab values and patient demographics were reviewed.
Results
Of the 118 post-cholecystectomy patients, 38 patients (31%) required intervention, and 80 patients (69%) did not require intervention after follow-up imaging. For both readers, axial and coronal CD diameters were significantly higher in the ‘intervention required’ vs ‘no intervention’ groups at all locations (
p
value < 0.05). There was good to excellent inter-reader agreement at all locations (ICC 0.68–0.92). Pertinent baseline lab values including AST (
p
= 0.043), ALT (
p
= 0.001), alkaline phosphatase (
p
= 0.0001), direct bilirubin (
p
= 0.011), total bilirubin (
p
= 0.028), and WBC (
p
= 0.043) were significantly higher in the ‘intervention required’ group. CD thresholds of 8 mm yielded the highest sensitivities (76–95%), and CD thresholds of 12 mm yielded the highest specificities (65–78%). CD combined with bilirubin levels increased sensitivity and specificity, compared to using either feature alone.
Conclusion
Dilated CD on CT combined with bilirubin levels increases the sensitivity and specificity for identifying patients needing intervention. We recommend that a post-cholecystectomy patient who presents with a CD diameter > 10 mm on CT and elevated bilirubin levels should undergo further clinical and imaging follow-up.
Graphical abstract</abstract><cop>New York</cop><pub>Springer US</pub><pmid>36104482</pmid><doi>10.1007/s00261-022-03660-9</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0003-2011-8084</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2366-0058 |
| ispartof | Abdominal imaging, 2022-12, Vol.47 (12), p.4126-4138 |
| issn | 2366-0058 2366-004X 2366-0058 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2714653482 |
| source | Springer Nature |
| subjects | Abdomen Alkaline phosphatase Bilirubin Cholecystectomy Computed tomography Diameters Dilatation Dilatation, Pathologic Gastroenterology Hepatobiliary Hepatology Humans Imaging Intervention Medical imaging Medicine Medicine & Public Health Patients Radiology Retrospective Studies Sensitivity Thresholds Tomography, X-Ray Computed |
| title | Utilizing CT to identify clinically significant biliary dilatation in symptomatic post-cholecystectomy patients: when should we be worried? |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-26T04%3A46%3A21IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Utilizing%20CT%20to%20identify%C2%A0clinically%C2%A0significant%20biliary%20dilatation%20in%20symptomatic%20post-cholecystectomy%20patients:%20when%20should%20we%20be%20worried?&rft.jtitle=Abdominal%20imaging&rft.au=Uko,%20Imo%20I.&rft.date=2022-12-01&rft.volume=47&rft.issue=12&rft.spage=4126&rft.epage=4138&rft.pages=4126-4138&rft.issn=2366-0058&rft.eissn=2366-0058&rft_id=info:doi/10.1007/s00261-022-03660-9&rft_dat=%3Cproquest_cross%3E2730896495%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c305t-7acb8fc2742ec044794f80aba64bb35dfecd3eae219af24328709315cf7198553%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2730896495&rft_id=info:pmid/36104482&rfr_iscdi=true |