title: Intraoperative cholangiography is still indicated after preoperative endoscopic cholangiography for gallstone disease.
abstract: BACKGROUND
  Intraoperative cholangiography (IOC) is frequently omitted in patients undergoing laparoscopic cholecystectomy (LC) if they have had successful preoperative endoscopic retrograde cholangiography (ERC).
  
  
  METHODS
  A prospectively maintained divisional laparoscopic cholecystectomy database was searched from 1991 to 1997 for patients who had IOC after preoperative ERC. The presence of recurrent or residual common duct stones seen on IOC and their impact on subsequent management were evaluated.
  
  
  RESULTS
  We identified a group of 127 patients who underwent preoperative ERC. Thirty-one patients (31/127, or 24%) went on to receive an IOC during cholecystectomy. In 15 patients whose preoperative ERC was reported normal, five (33%) had an abnormal IOC. In 16 patients whose ERC was reported as having cleared the duct, eight (50%) had an IOC abnormality. Eight of these 31 patients required a further procedure to clear the duct.
  
  
  CONCLUSIONS
  Retained or recurrent common duct stones at cholecystectomy following diagnostic or therapeutic ERC were more common than expected. Therefore, IOC is recommended during LC regardless of the findings yielded by the preoperative ERC.
authors: Department of Surgery, New York University School of Medicine, 530 First Avenue, New York, NY 10016, USA. michael.edye@med.nyu.edu
authors: M
authors: M
authors: Edye
authors: A
authors: A
authors: Dalvi
authors: J
authors: J
authors: Canin-Endres
authors: E
authors: E
authors: Baskin-Bey
authors: B
authors: B
authors: Salky
mesh_terms: D000328:Adult; D000368:Aged; D002758:Cholangiography / Q000379:methods*; D017081:Cholecystectomy, Laparoscopic / Q000379:methods; D002769:Cholelithiasis / Q000000981:diagnostic imaging / Q000601:surgery*; D003951:Diagnostic Errors / Q000379:methods; D016145:Endoscopy, Digestive System / Q000379:methods*; D005260:Female; D042882:Gallstones / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D011446:Prospective Studies; D012008:Recurrence; D017211:Treatment Failure