Selective operative cholangiography in the performance of laparoscopic cholecystectomy.
The objective of this prospective study was to evaluate the role of intraoperative cholangiography (IOC) for patients undergoing laparoscopic cholecystectomy (LC) to determine whether it could be safely omitted for all patients who fit standard criteria, namely normal liver function tests, no history of gallstone pancreatitis, common bile duct (CBD) diameter less than 10 mm or previous history of jaundice. Data were collected prospectively from 194 consecutive patients who had LC for symptomatic gall bladder disease. IOC was not performed in any patient. The conversion rate was 6.1% and one CBD injury occurred. Our experience demonstrates that LC performed without routine IOC does not result in an increased incidence of retained stones in selected patients who have no history of pancreatitis, normal liver function tests and CBD less than 10 mm diameter.
McFarlane
M E C
ME
Department of Surgery, Radiology, Anaesthetics and Intensive Care, University of the West Indies, Mona and Kingston Public Hospital, Jamaica. michaelm500@yahoo.com
Thomas
C A L
CA
McCartney
T
T
Bhoorasingh
P
P
Smith
G
G
Lodenquai
P
P
Mitchell
D I G
DI
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002758:Cholangiography; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000379:methods*; D042883:Choledocholithiasis / Q000000981:diagnostic imaging; D002769:Cholelithiasis / Q000601:surgery*; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011446:Prospective Studies; D017678:Sex Distribution