The impact of intraoperative cholangiography on recurrent pancreatitis and biliary complications in patients with gallstone pancreatitis.
BACKGROUND
Although gallstone pancreatitis is initiated by the presence of stones in the common bile duct, the benefit associated with routine intraoperative cholangiography at the time of cholecystectomy in these patients is unclear. The purpose of this study, using population-based data, was to determine the impact of cholangiography on clinical outcomes after cholecystectomy for gallstone pancreatitis.


METHODS
All patients who were admitted to hospital from January 1, 1997 to December 31, 2001 in Nova Scotia, Canada with pancreatitis who underwent cholecystectomy during the same admission were identified. The rates of recurrent pancreatitis and biliary complications after surgery were compared between patients who underwent cholecystectomy with intraoperative cholangiography ± common bile duct exploration and those who underwent cholecystectomy alone, using three linked administrative databases.


RESULTS
Three hundred thirty-two patients were identified, 119 had cholangiography at the time of cholecystectomy and 213 did not. After a median follow-up of after 3.8 years, there was no difference in the rate of recurrent pancreatitis or biliary complications between those who had cholangiography ± common bile duct exploration at the time of surgery and those who did not; 13.4 versus 10.8 %, respectively (p = 0.55).


CONCLUSIONS
These data suggest that intraoperative cholangiography does not improve outcomes after cholecystectomy for gallstone pancreatitis.
Division of General Surgery, Department of Surgery, Dalhousie University, Room 8-026 Centennial Building, Vitoria General Site, QEII HSC 1276 South Park St, Halifax, Nova Scotia, Canada, B3H 1C8. paul.johnson@dal.ca
Paul M
PM
Johnson
Mark J
MJ
Walsh
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002758:Cholangiography; D015331:Cohort Studies; D005260:Female; D042882:Gallstones / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D050500:Pancreatitis, Chronic / Q000453:epidemiology; D012189:Retrospective Studies; D055815:Young Adult