Intraoperative cholangiography during elective laparoscopic cholecystectomy: selective or routine use?

Silva, Alex Augusto; Camara, Carlos Augusto Canteras Raposo; Júnior, Aiodair Martins; Teles, Celso; Júnior, Júverson Alves Terra; Crema, Eduardo

doi:10.1590/s0102-86502013001000009

Cited by 9 publications

(6 citation statements)

References 18 publications

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“…Of cases where no CBD stone was suspected pre‐operatively, one was revealed on routine IOC in 1–4% of cases . In contrast, 22.4% of patients with a suspected CBD stone had this confirmed on IOC . Missed CBD stones were associated with a 15% readmission rate .…”

Section: Discussionmentioning

confidence: 99%

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Intraoperative cholangiogram during laparoscopic cholecystectomy: A clinical trial in rural setting

Verma

Wichmann

Gunning

et al. 2016

Australian J Rural Health

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The majority of patients treated in our centre were women, middle-aged patients booked for elective laparoscopic cholecystectomy. Although only 6.7% cases were suspicious for CBD stones pre-operatively, a total of 17% of patients with routine IOC suggested CBD stones. IOC was found to be safe, taking only an additional 28 min of total theatre time. Routine rather than selective use of IOC could be considered to improve patient safety and long-term results.

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Section: Discussionmentioning

confidence: 99%

“…The incidence of CBD stone detection pre‐operatively ranges from 5.4% to 13.6% . If pre‐operative US suggested CBD stones (based on a dilated CBD), 40% of operators recommended LC with IOC, 23% recommended pre‐operative MRCP, and the remainder recommended ERCP .…”

Section: Discussionmentioning

confidence: 99%

Intraoperative cholangiogram during laparoscopic cholecystectomy: A clinical trial in rural setting

Verma

Wichmann

Gunning

et al. 2016

Australian J Rural Health

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“…The operative time-consuming nature of intraoperative cholangiography has often been criticised in the literature and a careful preoperative assessment of the biliary tree has been advocated instead. [17][18][19] In our experience, an intraoperative cholangiography typically adds only a minimum of 10-15 minutes of operative time as it is routinely performed on all patients. Consequently, surgeon, operative team and radiographers are prepared for an intraoperative cholangiography during each laparoscopic cholecystectomy performed.…”

Section: Discussionmentioning

confidence: 99%

“…The current medical literature contains few prospective studies comparing intraoperative cholangiography and MRCP in the diagnosis of acute gallstone pancreatitis. 19,22 Thus, there remains a need for future prospective research in this field. In addition, because of our practice of rarely performing a preoperative MRCP before laparoscopic cholecystectomy, we do not have large numbers on which to base our conclusions regarding MRCP.…”

Section: Discussionmentioning

confidence: 99%

The role of intraoperative cholangiography in patients undergoing laparoscopic cholecystectomy for acute gallstone pancreatitis: is magnetic resonance cholangiopancreatography needed?

Thacoor

Pike

Pathak

et al. 2019

annals

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Introduction Intraoperative cholangiography is sporadically used in patients undergoing laparoscopic cholecystectomy to delineate common bile duct anatomy and exclude retained stones. In patients with acute gallstone pancreatitis, intraoperative cholangiography may reduce the need for preoperative magnetic resonance cholangiopancreatography. Materials and methods A retrospective review of a prospectively collected patient database was undertaken over a 15-year period. The primary objective was to evaluate intraoperative assessment of the common bile duct with intraoperative cholangiography in patients with acute gallstone pancreatitis. Results A total of 2215 patients underwent laparoscopic cholecystectomy between October 1998 and December 2013; 113 patients (of whom 77 were women) with a mean age of 54 years (range 16–88 years) were diagnosed with acute gallstone pancreatitis. Of these, 102 patients (90%) underwent laparoscopic cholecystectomy with intraoperative cholangiography, which was normal in 89 cases. Thirteen patients had choledocholithiasis on intraoperative cholangiography, 11 of whom were managed with concomitant trans-cystic duct exploration and clearance. Two patients required postoperative endoscopic retrograde cholangiopancreatography. Conclusions In patients diagnosed with acute gallstone pancreatitis, it is reasonable to proceed directly to surgery using intraoperative cholangiography on the same admission as the definitive assessment of the common bile duct. This negates the need for magnetic resonance cholangiopancreatography and can translate into cost savings and reduced length of stay.

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“…However, it is highly operator dependent and is not routinely performed by many surgeons 10 . However, it is a safe diagnostic method when performed selectively 18 .…”

Section: Discussionmentioning

confidence: 99%

Comparative Evaluation of Magnetic Resonance Cholangiopancreatography and Perioperative Cholangiography in Patients With Suspect Choledocholithiasis

Perales¹,

Souza²,

Crema³

2019

ABCD, arq. bras. cir. dig.

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Background:Cholelithiasis is a highly prevalent condition, and choledocholitiasis is a high morbidity complication and requires accurate methods for its diagnosis. Aim:To evaluate the population of patients with suspected choledocholitiasis and check the statistical value of magnetic resonance cholangiopancreatography, ultrasonography, the laboratory and the clinic of these patients comparing them to the results obtained by perioperative cholangiography. Methods:This is a retrospective cohort study, which were evaluated 76 patients with cholelithiasis and suspected choledocholithiasis. Results:It was observed that the presence of dilatation of the biliary tract or choledocholithiasis in the ultrasonography was four and eight times increased risk of perioperative cholangiography for positive choledocholithiasis, respectively. For each unit increased in serum alkaline phosphatase was 0.3% increased the risk of perioperative cholangiography for positive choledocholithiasis. In the presence of dilatation of the bile ducts in the ultrasonography was four times greater risk of positive magnetic resonance cholangiopancreatography for choledocholithiasis. In the presence of pancreatitis these patients had five times higher risk of positive magnetic resonance cholangiopancreatography for choledocholithiasis. On the positive magnetic resonance cholangiopancreatography presence to choledocholithiasis was 104 times greater of positive perioperative cholangiography for choledocholithiasis. Conclusions:The magnetic resonance cholangiopancreatography is a method with good accuracy for propedeutic follow-up for the diagnosis of choledocholithiasis, consistent with the results obtained from the perioperative cholangiography; however, it is less invasive, with less risk to the patient and promote decreased surgical time when compared with perioperative cholangiography.

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Intraoperative cholangiography during elective laparoscopic cholecystectomy: selective or routine use?

Cited by 9 publications

References 18 publications

Intraoperative cholangiogram during laparoscopic cholecystectomy: A clinical trial in rural setting

Intraoperative cholangiogram during laparoscopic cholecystectomy: A clinical trial in rural setting

The role of intraoperative cholangiography in patients undergoing laparoscopic cholecystectomy for acute gallstone pancreatitis: is magnetic resonance cholangiopancreatography needed?

Comparative Evaluation of Magnetic Resonance Cholangiopancreatography and Perioperative Cholangiography in Patients With Suspect Choledocholithiasis

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