A survey of the accuracy of interpretation of intraoperative cholangiograms

Pandanaboyana, Sanjay; Tagolao, Sherry; Dirkzwager, Ilse; Bartlett, Adam

doi:10.1111/j.1477-2574.2012.00501.x

Cited by 27 publications

(16 citation statements)

References 21 publications

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“…BDI is associated with a mortality rate of 12.5%, and increased the mortality rate of patients undergoing LC (3.9% compared with 1.1% at one year) . Achieving the ‘critical view of safety’ via dissection of Calot's triangle and IOC have both been advocated as gold standard for preventing BDI in LC . Routine IOC was found to reduce the incidence of BDI by up to 50–70% .…”

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 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%

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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“…However, IOC will not prevent the occurrence of all BDI . It has also been shown that IOCs may often be misinterpreted . Nonetheless, at a population level routine IOC is likely to be cost‐effective .…”

Section: Discussionmentioning

confidence: 99%

Using a standardized method for laparoscopic cholecystectomy to create a concept operation-specific checklist

Connor

Perry

Nathanson

et al. 2014

HPB

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Section: Discussionmentioning

confidence: 99%

“…It is impossible to reflect retrospectively whether the anomalies were identified and subsequently not recorded on the operative report or whether they were not recognized. In a study by Sanjay et al 28 15 IOCs were digitalized, de-identified and interpreted by consultant surgeons and trainees. As in our study, there was a trend of improved reporting accuracy when surgeons were stratified by seniority, with 30% of consultants correctly identifying variants of normal biliary anatomy compared with 25% of trainees.…”

Section: Discussionmentioning

confidence: 99%

Intraoperative detection of aberrant biliary anatomy via intraoperative cholangiography during laparoscopic cholecystectomy

Chehade

Kakala

Sinclair

et al. 2019

ANZ Journal of Surgery

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Background Laparoscopic cholecystectomy (LC) is the standard of treatment for symptomatic cholelithiasis. Although intraoperative cholangiography (IOC) is widely used as an adjunct to LC, there is still no worldwide consensus on the value of its routine use. Anatomical studies have shown that variations of the biliary tree are present in approximately 35% of patients with variations in right hepatic second‐order ducts being especially common (15–20%). Approximately, 70–80% of all iatrogenic bile duct injuries are a consequence of misidentification of biliary anatomy. The purpose of this study was to assess the adequacy of and the reporting of IOCs during LC. Methods IOCs obtained from 300 consecutive LCs between July 2014 and July 2016 were analysed retrospectively by two surgical trainees and confirmed by a radiologist. Biliary tree anatomy was classified from IOC films as described by Couinaud (1957) and correlated with documented findings. The accuracy of intraoperative reporting was assessed. Biliary anatomy was correlated to clinical outcome. Results A total of 95% of IOCs adequately demonstrated biliary anatomy. Aberrant right sectoral ducts were identified in 15.2% of the complete IOCs, and 2.6% demonstrated left sectoral or confluence anomalies. Only 20.4% of these were reported intraoperatively. Bile leaks occurred in two patients who had IOCs (0.73%) and two who did not (7.4%). Conclusion Surgeons generally demonstrate biliary anatomy well on IOC but reporting of sectoral duct variation can be improved. Further research is needed to determine whether anatomical variation is related to ductal injury.

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A survey of the accuracy of interpretation of intraoperative cholangiograms

Cited by 27 publications

References 21 publications

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

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

Using a standardized method for laparoscopic cholecystectomy to create a concept operation-specific checklist

Intraoperative detection of aberrant biliary anatomy via intraoperative cholangiography during laparoscopic cholecystectomy

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