Is intravenous cholangiography an alternative to the routine per-operative cholangiogram?
Ultrasonography, although an accurate method of detecting stones within the gall bladder, is unreliable for the detection of bile duct stones for which per-operative cholangiography remains the standard investigation. Fifty seven patients undergoing elective cholecystectomy had both a pre-operative intravenous cholangiogram and per-operative cholangiography. The pre-operative investigation is shown to be at least as effective in the detection of common bile duct stones and only missed a duct stone in one patient. The substitution of pre-operative intravenous cholangiography for routine per-operative cholangiography would result in a significant reduction in operating time, may provide advance knowledge on the biliary anatomy and would allow advance planning of the likely procedure. It is suggested that pre-operative intravenous cholangiography, carried out on the day of admission, should be considered as a preferred alternative investigation to per-operative cholangiography.
Huddy
S P
SP
Epsom District Hospital, Surrey, UK.
Southam
J A
JA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002758:Cholangiography / Q000592:standards*; D002763:Cholecystectomy; D002769:Cholelithiasis / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D014463:Ultrasonography