Results of routine intraoperative cholangiography in laparoscopic cholecystectomy

Abstract

Background The use of intraoperative cholangiography (IOC) has proved controversial in both open and laparoscopic cholecystectomy (LC). Our aim was to evaluate the use of routine IOC during laparoscopic cholecystectomy over a 3-year period. Methods Laparoscopic cholecystectomy was performed in 450 patients. Preoperative endoscopic retrograde cholangiography (ERCP) was performed in 14 patients, in whom stones were removed. IOC was attempted in 436 patients and was successfully performed in 394 of these (90%). Results In 18 patients (4.6%), IOC detected bile-duct stones, in two patients a cholecystoduodenal fistula and in one a partial section of the bile duct. The cystic duct was torn in one patient. IOC gave one false-positive and one false-negative result. Conclusions In laparoscopic surgery IOC should be mandatory. It is a safe procedure that is useful to detect stones in the bile duct and to recognise bile-duct injuries during the operation.