title: The Feasibility and Safety of Laparoscopic Cholecystectomy Approach without the Intraopertative Cholangiography Use: A Retrospective Study on 750 Consecutive Patients.
abstract: BACKGROUND
  We have retrospectively reviewed the results of all common bile duct (CBD)-stone preoperative asymptomatic patients operated on our unit to point out the feasibility and safety of the laparoscopic cholecystectomy approach without the IOC use.
  
  
  METHODS
  From January 2004 and June 2008 we analyzed all the data from hospital records and follow up results of all the patients who underwent LC. The indications for performing preoperative endoscopic retrograde cholangiopancreatography (ERCP) or selective IOC were abnormal liver function tests, history of jaundice, cholangitis or pancreatitis, and ultrasonographic evidence of CBD stone or dilation (≥ 10 mm). These patients were excluded from study. The follow up of the all patients were done by liver function tests and abdominal ultrasonography when needed at the time of the visit.
  
  
  RESULTS
  Between January 2006 and June 2010, 750 patients were operated in our clinic. In 34 patients, operations were converted to open cholecystectomy (OC). Of these 750 patients, 98 of them had one or more exclusion criteria and were excluded from the further analyzes. We did not perform any IOC during LC. Regular follow up of at least two years was obtained in 618 (618/657, 94.0%) patients. No operative mortality was encountered among the patients. Postoperative morbidity was detected in 15 of the patients (2.5%). In one patient, CBD injury was detected (0.017%). The mean follow up was 35 (24 - 74) months. Retained stone was detected in three patients (3/577, 0.5%) during the follow up.
  
  
  CONCLUSIONS
  This approach allows to omit routine IOC and to perform LC safely in selected patients group given the low percentage of both CBD injuries and symptomatic retained stones observed in the late follow up period in our 618 operated patients, we consider our approach a feasible and safe approach to manage patients with gallbladder stones re-confirming the results of other studies.
authors: Ataturk Educational and Research Hospital 1st Surgical Department, Izmir, Turkey.
authors: Kemal
authors: K
authors: Atahan
authors: Ataturk Educational and Research Hospital 1st Surgical Department, Izmir, Turkey.
authors: Serhat
authors: S
authors: Gur
authors: Ataturk Educational and Research Hospital 1st Surgical Department, Izmir, Turkey.
authors: Evren
authors: E
authors: Durak
authors: Ataturk Educational and Research Hospital 1st Surgical Department, Izmir, Turkey.
authors: Atilla
authors: A
authors: Cokmez
authors: Ataturk Educational and Research Hospital 1st Surgical Department, Izmir, Turkey.
authors: Ercument
authors: E
authors: Tarcan
keywords: Gallstone disease; Intraoperative cholangiography; Laparoscopic cholecystectomy