title: Intraoperative cholangiography using an endoscopic nasobiliary tube during a laparoscopic cholecystectomy.
abstract: OBJECTIVE
  The goals of this report are to present the characteristics of biliary complications associated with laparoscopic cholecystectomies (LC) performed at a single center, and to evaluate the efficacy of intraoperative cholangiography (IOC) using an endoscopic nasobiliary tube (ENBT) during an LC in order to prevent biliary complications.
  
  
  METHODS
  A retrospective audit was conducted on a total of 657 patients who underwent either LC or open cholecystectomies (OC). There were 19 patients who developed bile duct injury (BDI; n = 9) or bile leakage (BL; n = 10) during an LC and were actively treated. After May of 1999, the patients with a higher risk of developing biliary complications were selected for preoperative placement of an ENBT, and IOC was performed.
  
  
  RESULTS
  Intraoperative cholangiography using ENBT was performed on 93 (27.1%) out of 343 patients who underwent either LC or OC after May of 1999. An LC was performed in 335 cases (97.7%), and a conversion from an LC to OC was necessary in only three cases. Even though BDI never occurred, BL from the cystic duct and gallbladder bed were recognized in five cases.
  
  
  CONCLUSIONS
  The selective use of IOC using ENBT may help to prevent BDI during LC, thereby expanding the indications for LC, while also reducing the rate of conversion to open procedures.
authors.affiliation: Department of Surgery, Oita Prefectural Hospital, 476 Oaza-Bunyou, Oita, 870-8511, Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ikeda
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Yonemura
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Ueda
authors.forename: Akira
authors.initials: A
authors.lastname: Kabashima
authors.forename: Kohjiro
authors.initials: K
authors.lastname: Mashino
authors.forename: Kizuku
authors.initials: K
authors.lastname: Yamashita
authors.forename: Kyuzo
authors.initials: K
authors.lastname: Fujii
authors.forename: Hideya
authors.initials: H
authors.lastname: Tashiro
authors.forename: Hisanobu
authors.initials: H
authors.lastname: Sakata
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001652:Bile Ducts / Q000293:injuries; D002758:Cholangiography; D002763:Cholecystectomy; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D004322:Drainage / Q000295:instrumentation; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D055815:Young Adult