title: Intraoperative cholangiography revisited.
abstract: The charts of 1351 patients undergoing cholecystectomy at our institutions from 1985 through 1989 were reviewed retrospectively to evaluate the indications for and the success of intraoperative cholangiography. A total of 800 patients underwent intraoperative cholangiography. They were divided into two groups based on the absence (CR-) or presence (CR+) of clinical and/or operative criteria suggestive of the existence of common bile duct stones. Intraoperative cholangiography in CR- patients was of limited benefit, being negative (normal) in 95.7%, true-positive (abnormal) in 3.3%, and false-positive in 1%. False-positive intraoperative cholangiography resulted in unnecessary common bile duct explorations. Intraoperative cholangiography in CR+ patients proved useful, avoiding unnecessary common bile duct exploration in 55%. In those select CR+ patients with palpable common bile duct stones or cholangitis, little additional information was gained by the intraoperative cholangiography. We conclude that routine screening intraoperative cholangiography in CR- patients be reconsidered, as should the use of intraoperative cholangiography in CR+ patients with a palpable common bile duct stone or cholangitis. Intraoperative cholangiography in the remainder of CR+ patients proved beneficial and should be continued.
authors.affiliation: Department of Surgery, Long Island Jewish Medical Center Affiliation, Queens Hospital Center, Jamaica, NY 11432.
authors.forename: B W
authors.initials: BW
authors.lastname: Pace
authors.forename: J
authors.initials: J
authors.lastname: Cosgrove
authors.forename: B
authors.initials: B
authors.lastname: Breuer
authors.forename: I B
authors.initials: IB
authors.lastname: Margolis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002758:Cholangiography; D002761:Cholangitis / Q000150:complications / Q000601:surgery; D002763:Cholecystectomy; D002764:Cholecystitis / Q000150:complications / Q000601:surgery; D005069:Evaluation Studies as Topic; D005189:False Positive Reactions; D005260:Female; D042882:Gallstones / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications / Q000601:surgery; D012189:Retrospective Studies