title: Intraoperative cholangiography during elective laparoscopic cholecystectomy: selective or routine use?
abstract: OBJECTIVE
  To investigate clinical, laboratory and ultrasonographic parameters in patients with and without preoperative criteria for intraoperative cholangiography (IOC) during laparoscopic cholecystectomy in order to define predictive factors of choledocolithiasis.
  
  
  METHODS
  As a criterion for inclusion in the study the patients should present chronic calculous cholecystitis in the presence or absence of any recent clinical, laboratory of ultrasonographic finding suggesting choledocolithiasis, who were therefore submitted to cholangiography during surgery.
  
  
  RESULTS
  A total of 243 laparoscopic cholecystectomies with IOC were performed on patients with chronic calculous cholecystitis with or without a preoperative formal indication for contrast examination. Choledocolithiasis was detected in 33 (13.58%) of the 243 patients studied. The incidence of previously unsuspected choledocolithiasis was only one case (1.0%) among 100 patients without an indication for this exam. However, 32 (22.37%) cases of choledocolithiasis were observed among the 143 patients with a preoperative indication for IOC.
  
  
  CONCLUSIONS
  The use of selective cholangiography is safe for the diagnosis of choledocolithiasis. Only 22.37% of the cholangiography results were positive in cases of suspected choledocolithiasis.
authors.forename: Alex Augusto
authors.initials: AA
authors.lastname: Silva
authors.forename: Carlos Augusto Canteras Raposo
authors.initials: CA
authors.lastname: Camara
authors.forename: Aiodair
authors.initials: A
authors.lastname: Martins
authors.forename: Celso Júnior Oliveira
authors.initials: CJ
authors.lastname: Teles
authors.forename: Júverson Alves
authors.initials: JA
authors.lastname: Terra
authors.forename: Eduardo
authors.initials: E
authors.lastname: Crema
mesh_terms: D000328:Adult; D002758:Cholangiography / Q000379:methods*; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D002764:Cholecystitis / Q000000981:diagnostic imaging / Q000601:surgery*; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D014463:Ultrasonography