An Easy and Effective Method of Cholangiography in Laparoscopic Cholecystectomy: Laparoscopic Cholecystocholangiography

Abstract

Cholecystocholangiography is a valid alternative to cystic duct catheterization in its ability to achieve intra-operative cholangiography in the setting of laparoscopic cholecystectomy.

Intraoperative assessment of biliary anatomy for prevention of bile duct injury: a review of current and future patient safety interventions

“…Also, CCC yielded inferior image quality and a 2.3 times longer radiation exposure. In comparative studies, Daoud et al [59] reported comparable success rates for CCC and IOC, while Glattli et al [60] found a very low success rate of 36% for CCC versus 90% in IOC. In general, success rates CCC series vary between 72 and 90% [61–64].…”

“…In general, success rates CCC series vary between 72 and 90% [61–64]. CCC reduces operative time compared to IOC [58]; times necessary to perform CCC are quoted as between 2 and 14 min [59, 61, 64]. The Kumar clamp for “partial” CCC was used in only two series, with success rates of 98 and 83% [65, 66].…”

A Randomized Controlled Trial Comparing Cholecystocholangiography With Cystic Duct Cholangiography During Laparoscopic Cholecystectomy

“…The use of the Veress needle for gall bladder puncture was chosen because it required no special equipment or additional expense, and it is well described. 5,7 Alternative methods include the use of a two‐part cannula; 3,11 a spinal needle; 6 an endoscopic needle that fits down a 5‐mm port; 4,9 or a double balloon. 7 The use of a Veress needle rather than a double balloon or conical needle may have increased the rate of submucosal oedema, 4,7 although this was not classified as a problem.…”

“…3,4,7,11 Acute cholecystitis contributes to this failure rate. 4,7 Twenty-eight per cent of gall bladders in the present series were operated on for acute symptoms and although this influenced the success rate for CCC, the study population is representative of the standard casemix presenting for cholecystectomy. 12 Many of the trials assessing cholangiography fail to provide objective measures for cholangiogram quality.…”

A reliable method for handling the “difficult” cystic duct to obtain a good cholangiogram during laparoscopic cholecystectomy

“…The lower end of the range for the selective policy may result from less frequent practice of the technique when the selective policy is adopted or because some of the selective cases will be technically difficult precisely because of the indication for IOC in the first place [8]. A method of cholangiography through the gallbladder (cholecystocholangiography) has been described by some investigators as a valid alternative to cystic duct catheterization [2].…”