Intraoperative cholangiography is still indicated after preoperative endoscopic cholangiography for gallstone disease.
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.
Edye
M
M
Department of Surgery, New York University School of Medicine, 530 First Avenue, New York, NY 10016, USA. michael.edye@med.nyu.edu
Dalvi
A
A
Canin-Endres
J
J
Baskin-Bey
E
E
Salky
B
B
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