Operative cholangiography in the laparoscopic era: a retrospective review of the quality and interpretation of this investigation.
BACKGROUND
Operative cholangiograms during the year of introduction of laparoscopic cholecystectomy were reviewed to examine their quality and interpretation.


METHODS
149 operative cholangiogram films (34 open and 115 laparoscopic) were reviewed retrospectively by a panel and scored for their ability to demonstrate biliary anatomy and detect bile duct stones.


RESULTS
Cholangiography performed by the cystic duct was of similar quality, whether performed laparoscopically or open. Cholangiography via the cystic duct (conventional films) produces superior results for both anatomical delineation and detection of choledocholithiasis (80% adequate) than cholangiography performed by direct gallbladder puncture (29-35% adequate).


CONCLUSIONS
There is no clear evidence to suggest that an intra-operative specialist radiological review of cholangiograms performed by the cystic duct would improve the detection of bile duct stones.
Draganic
B
B
Department of Surgery, John Hunter Hospital, New Lambton Heights, New South Wales, Australia.
Perry
R
R
Gani
J
J
D001662:Biliary Tract Surgical Procedures; D002758:Cholangiography / Q000379:methods* / Q000592:standards*; D006761:Hospitals; D006801:Humans; D009517:New South Wales; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies