INTRA-OPERATIVE CHOLANGIOGRAPHY DURING LAPAROSCOPIC CHOLECYSTECTOMY. IS IT ESSENTIAL?

Document Type : Original Article

Authors

General Surgery Department, Ain Shams University, Egypt

Abstract

Aim: The aim of this work is to assess the value of using intraoperative cholangiogram during laparoscopic 
cholecystectomy.
Methods: Thirty patients scheduled for laparoscopic cholecystectomy were subjected to intraoperative 
cholangiogram in the period between June 2006 and June 2009. 
Results: Four (13%) cholangiograms revealed short wide cystic ducts. Three (10%) cholangiograms revealed 
stones in the CBD. One of them was totally unsuspected preoperatively. The remaining two patients had 
mild elevation of liver enzymes preoperatively, without any clinical evidence. The operative time for the 
cholangiography procedure was 25 (15-40) minutes.
Conclusions: Despite the increased operative time in using intraoperative cholangiogram, it helps to 
identify abnormal anatomy especially in difficult cases, avoid leaving an excessive length of the cystic duct 
stump and detect unsuspected biliary duct stones. Intraoperative cholangiogram is recommended especially 
in difficult cases and with unclear anatomy. Surgeons should train themselves to use operative 
cholangiography to the point of perfection and should have a low threshold for performing it to define 
ductal anatomy.

Keywords

The Egyptian Journal of Surgery
Volume 30, Issue 1
January 2011
Pages 19-23

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