title: Selective cholangiography with laparoscopic cholecystectomy: review of a protocol.
abstract: OBJECTIVE
  To report the results of a protocol for the preoperative diagnosis of stones in the common bile duct in patients with symptomatic cholelithiasis.
  
  
  METHODS
  Prospective open study.
  
  
  METHODS
  District general hospital, United Kingdom.
  
  
  METHODS
  Ultrasonography and liver function tests, and in selected patients preoperative cholangiography.
  
  
  METHODS
  The ability of the investigations to diagnose stones in the common bile duct preoperatively.
  
  
  RESULTS
  Ultrasonography or liver function tests, or both indicated that 53 patients were at low risk of having stones in the common duct, and they underwent laparoscopic cholecystectomy without further investigation. A further 38 patients had minor abnormalities on the first two investigations and underwent intravenous cholangiography; ductal stones were identified in 6. Nine patients were thought to be at high risk and so underwent endoscopic retrograde cholangiopancreatography (ERCP) or open exploration of the common bile duct, and stones were found in 5. No further stones have been identified after a minimum follow up of 12 months.
  
  
  CONCLUSIONS
  Selective preoperative cholangiography is a reliable way of detecting stones in the common bile duct before laparoscopic cholecystectomy.
authors.affiliation: Department of Surgery, Cheltenham General Hospital, England.
authors.forename: S W
authors.initials: SW
authors.lastname: Galloway
authors.forename: J M
authors.initials: JM
authors.lastname: Blazeby
authors.forename: B R
authors.initials: BR
authors.lastname: Tulloh
authors.forename: K R
authors.initials: KR
authors.lastname: Poskitt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002758:Cholangiography; D017081:Cholecystectomy, Laparoscopic; D002769:Cholelithiasis / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D042882:Gallstones / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D014463:Ultrasonography