Analysis of pancreaticobiliary ductal union based on intraoperative cholangiography in patients undergoing laparoscopic cholecystectomy.
BACKGROUND
In order to diagnose pancreaticobiliary maljunction (PBM), it is necessary to perform direct fluoroscopic examinations of the biliary tract system. For patients with benign biliary diseases, these examinations are performed only in selected cases, because they are generally invasive. We investigated whether intraoperative cholangiography was practicable in evaluating the presence of PBM in patients with benign biliary diseases who underwent laparoscopic cholecystectomy (LC).


METHODS
Between March 1998 and February 2001, intraoperative cholangiography (IOCG), which is one of the direct fluoroscopic examinations, was attempted in all 100 patients who underwent LC.


RESULTS
IOCG was completed successfully in 98 patients (98.0%). No complications associated with IOCG occurred. In 13 (13.3%) of 98 patients, IOCG showed reflux of contrast medium into the pancreatic duct through a common channel. 'A long common channel' was observed in 8 cases (8.2%), suggesting the presence of PBM.


CONCLUSIONS
These results suggest that IOCG in LC may be a practicable method for detecting the presence of PBM.
Fujisaki
S
S
First Dept. of Surgery, Nihon University School of Medicine, Tokyo, Japan. sfujisak@med.nihon-u.ac.jp
Tomita
R
R
Koshinaga
T
T
Fukuzawa
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017734:Bile Ducts, Extrahepatic / Q000002:abnormalities* / Q000000981:diagnostic imaging; D002758:Cholangiography; D017081:Cholecystectomy, Laparoscopic; D003135:Common Bile Duct / Q000002:abnormalities / Q000000981:diagnostic imaging; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000002:abnormalities* / Q000000981:diagnostic imaging