Routine cholangiography reduces sequelae of common bile duct injuries.
BACKGROUND
An effort was made to determine whether a policy of routine cholangiography affects the incidence, morbidity, and cost of bile duct injuries.


METHODS
A retrospective review of consecutive 3,242 laparoscopic cholecystectomies was performed. Most patients had routine intraoperative cholangiography.


RESULTS
There were 12 bile duct injuries (0.37%). All injuries were Bismuth levels 1 and 2. Eleven of 12 injuries were recognized intraoperatively. Ten were repaired primarily and one required hepaticojejunostomy. All repairs were successful. Average hospital charges were $26,669. One of 12 patients had delayed recognition of a bile duct injury and underwent primary repair over a T-tube on postoperative day 7. Hospital charges were $43,957.


CONCLUSIONS
Routine cholangiography did not appear to decrease the absolute incidence of bile duct injuries compared to previously published reports. Injury severity, morbidity, late sequelae, and costs were reduced by a policy of routine cholangiography.
Carroll
B J
BJ
Division of Surgery, Cedars-Sinai Medical Center, 8635 W. 3rd Street, Suite 795W, Los Angeles, CA 90048, USA.
Friedman
R L
RL
Liberman
M A
MA
Phillips
E H
EH
D002758:Cholangiography; D017081:Cholecystectomy, Laparoscopic; D003135:Common Bile Duct / Q000293:injuries*; D005260:Female; D017722:Hospital Charges; D006801:Humans; D007049:Iatrogenic Disease; D007431:Intraoperative Complications / Q000191:economics / Q000517:prevention & control*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies