Routine intraoperative cholangiography is feasible and efficient during laparoscopic cholecystectomy
Millat, B.; Deleuze, A.; de Saxce, B.; de Seguin, C.; Fingerhut, A.
Hepato-Gastroenterology 44(13): 22-27
1997
ISSN/ISBN: 0172-6390 PMID: 9058113 Document Number: 483171
Background/Aims: This is the evaluation of the feasibility and results of routine laparoscopic intraoperative cholangiography. Patients and Methods: A multicentric prospective study in 315 consecutive patients undergoing elective or urgent laparoscopic cholecystectomy. Results: The success rate was 94%. Mean duration of intraoperative cholangiography was 12 min. Sixteen of 18 failures were related to a narrow cystic duct. One cystic duct avulsion (ligated under laparoscopy) and 2 false positive cholangiograms (1 transcystic exploration, 1 conversion) were noted. Intraoperative cholangiography revealed aberrant bile ducts possibly at risk to injury from dissection in four patients (1.3 per cent). Intraoperative cholangiography disclosed unsuspected stones in 10 patients (4%). Forty-five patients had a preoperative suspicion of choledocholithiasis: choledocholithiasis were found at intraoperative cholangiography in 3 of 13 patients who had preoperative endoscopic sphincterotomy for stone extraction, in 1 of 11 patients with normal preoperative endoscopic cholangiography, and in 11 of 21 patients undergoing surgery alone (57%). Conclusion: If complete clearance of choledocholithiasis is to remain the objective of surgical treatment of biliary lithiasis including laparoscopic cholecystectomy, then routine intraoperative cholangiography is feasible and efficient.