“…Ludwig et al, in a German study, found that only 6% of institutions use perioperative cholangiography (POC) systematically during LCs, 49.5% of them use it selectively and 43% of institutions do not perform any diagnostic procedure at the time of LC 3 . Although the systematic use of POC is still defended by a considerable number of surgeons who choose for the perioperative instrumentation of the biliary duct, the largest part argues that the POC, conducted in a systematic way, has not been cost-effective 4 , increasing operative time and the number of false-positive diagnoses, overestimating choledocholitiasis 5,6 , and especially increasing the proportion of patients undergoing unnecessary instrumentation of the biliary tract with the inherent risks of morbidity and mortality 5,7 . Matthew et al, in a meta-analysis, reported 4,209 preoperatively POCs performed in unsuspected patients for gallstones in the bile duct.…”