title: A survey of the accuracy of interpretation of intraoperative cholangiograms.
abstract: OBJECTIVE
  There are few data in the literature regarding the ability of surgical trainees and surgeons to correctly interpret intraoperative cholangiograms (IOCs) during laparoscopic cholecystectomy (LC). The aim of this study was to determine the accuracy of surgeons' interpretations of IOCs.
  
  
  METHODS
  Fifteen IOCs, depicting normal, variants of normal and abnormal anatomy, were sent electronically in random sequence to 20 surgical trainees and 20 consultant general surgeons. Information was also sought on the routine or selective use of IOC by respondents.
  
  
  RESULTS
  The accuracy of IOC interpretation was poor. Only nine surgeons and nine trainees correctly interpreted the cholangiograms showing normal anatomy. Six consultant surgeons and five trainees correctly identified variants of normal anatomy on cholangiograms. Abnormal anatomy on cholangiograms was identified correctly by 18 consultant surgeons and 19 trainees. Routine IOC was practised by seven consultants and six trainees. There was no significant difference between those who performed routine and selective IOC with respect to correct identification of normal, variant and abnormal anatomy.
  
  
  CONCLUSIONS
  The present study shows that the accuracy of detection of both normal and variants of normal anatomy was poor in all grades of surgeon irrespective of a policy of routine or selective IOC. Improving operators' understanding of biliary anatomy may help to increase the diagnostic accuracy of IOC interpretation.
authors.affiliation: Hepatopancreaticobiliary Unit, Department of General Surgery, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK. sanjay.pandanaboyana@nhs.net
authors.forename: Pandanaboyana
authors.initials: P
authors.lastname: Sanjay
authors.forename: Sherry
authors.initials: S
authors.lastname: Tagolao
authors.forename: Ilse
authors.initials: I
authors.lastname: Dirkzwager
authors.forename: Adam
authors.initials: A
authors.lastname: Bartlett
mesh_terms: D001659:Biliary Tract / Q000002:abnormalities / Q000000981:diagnostic imaging*; D002758:Cholangiography; D017081:Cholecystectomy, Laparoscopic; D002983:Clinical Competence; D019538:Health Care Surveys; D006801:Humans; D007430:Intraoperative Care; D015588:Observer Variation; D011237:Predictive Value of Tests; D015203:Reproducibility of Results