title: Operative cholangiography reassessed.
abstract: This study compares a surgeon's clinical impression of the common bile duct (CBD) at the time of operation with his assessment of it following an operative cholangiogram. It also compares the accuracy of the surgeon's radiological assessment with that of a consultant radiologist. In a series of 100 consecutive cholecystectomies 92 patients had operative cholangiograms. In the remaining eight cases no cholangiogram was performed for technical reasons in five and the presence of large stones in three. In the 92 patients who did have cholangiograms, there was clinical and radiological agreement on the state of the CBD in 80 patients. On the basis of the surgeon's interpretation there were six clinical false negatives and six radiological false positives, but only one false negative and one false positive when the films were reported by a radiologist. It is concluded that unless operative cholangiography is interpreted with the help of a radiologist the technique adds very little information regarding the CBD than has already been gained by pre-operative investigations and laparatomy.
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002758:Cholangiography; D002763:Cholecystectomy; D003135:Common Bile Duct / Q000000981:diagnostic imaging; D005260:Female; D042882:Gallstones / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged