Intravenous cholangiography before 1000 consecutive laparoscopic cholecystectomies

Berggren, Per Olof; Faragó, I; Gabrielsson, N; Thor, K

doi:10.1046/j.1365-2168.1997.02611.x

Cited by 3 publications

(4 citation statements)

References 15 publications

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“…For these reasons we believe, in accordance with many laparoscopic surgeons [9], that the sequence ES ϩ LC is today the best approach to cholecystocholedocholithiasis, and the workup we propose allows it. Our success rate has been high, in keeping with reported series [11,52], and the complication rate is low.…”

Section: Sequential Endoscopic-laparoscopic Treatment Of Cholecystoch...supporting

confidence: 90%

“…With the advent of LC there has been a resurgence of interest in the potential role of preoperative intravenous cholangiography (IVC) as an alternative for evaluating the CBD [9,10]. The reported experiences in this regard have yielded contradicting results [11][12][13]. The purpose of this survey was to assess whether a diagnostic workup based on routine preoperative IVC, which permits selective use of IOC and the preoperative endoscopic treatment of CBD stones, could be useful in patients undergoing LC.…”

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confidence: 99%

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Five‐year Prospective Audit of Routine Intravenous Cholangiography and Selective Endoscopic Retrograde Cholangiography with or without Intraoperative Cholangiography in Patients Undergoing Laparoscopic Cholecystectomy

et al. 2000

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Consensus has never been reached regarding the need or the imaging technique for evaluating the common bile duct (CBD) in patients considered for cholecystectomy. With the advent of laparoscopic cholecystectomy there has been a resurgence of interest in the role of preoperative intravenous cholangiography (IVC) as an alternative for evaluating the CBD. The purpose of this audit was to assess whether a diagnostic workup based on IVC, which permits selective use of intraoperative cholangiography (IOC) and endoscopic treatment of CBD stones before surgery, could be useful in patients undergoing laparoscopic cholecystectomy (LC). In patients without jaundice, gallstone pancreatitis, a prior diagnosis of CBD stones, a prior history of contrast allergy, or a risk of contrast-associated acute renal failure, IVC was performed routinely. Patients suspected to have CBD stones based on IVC results or with inconclusive IVC and patients with a strong clinical suspicion of CBD stones were referred for endoscopic retrograde cholangiography (ERC). IOC was carried out in patients who had a history of contrast allergy or risk of contrast-associated acute renal failure and whenever the surgeon was in doubt as to the biliary anatomy or CBD clearance. IVC was carried out in 1155 patients, ERC in 225, and IOC in 54. IVC was conclusive in 1132 patients, with a diagnostic accuracy of 99%. Our workup permitted the sequential endoscopic-laparoscopic treatment of cholecystocholedocholithiasis in 162 cases. During the follow-up period residual CBD stones were detected in four patients. Our diagnostic workup showed that routine IVC exposes the population to a large radiation burden, and the cost is high for the small number of patients who benefit. Moreover, it does not seem helpful in reducing the incidence of CBD injuries during LC.

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Section: Sequential Endoscopic-laparoscopic Treatment Of Cholecystoch...supporting

confidence: 90%

mentioning

confidence: 99%

Five‐year Prospective Audit of Routine Intravenous Cholangiography and Selective Endoscopic Retrograde Cholangiography with or without Intraoperative Cholangiography in Patients Undergoing Laparoscopic Cholecystectomy

et al. 2000

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“…In the majority of cases these can be removed endoscopically. Magnetic resonance cholangiography (MRC), intravenous cholangiography, and spiral CT after infusion cholangiography are all noninvasive techniques with impressive sensitivities at detecting common bile duct stones (Table 2) [19][20][21][22]. Of these modalities, MRC provides the best anatomic detail and has also proven quite good at diagnosing other causes of biliary obstruction.…”

Section: Biliary Tract Imagingmentioning

confidence: 99%

Biliary tract surgery

Ahrendt

1999

Curr Gastroenterol Rep

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The use of the laparoscope in biliary tract surgery continues to play a major role in improving the operative management of patients with biliary diseases. Laparascopic cholecystectomy has been safely performed as a day-case procedure and has lowered the morbidity of cholecystectomy in the setting of acute cholecystitis. Laparoscopic common bile duct exploration allows cholecystectomy and the removal of common bile duct stones to be performed during the same procedure, thereby decreasing hospital stay. Several new noninvasive modalities have been recently developed to image the biliary tract. In addition, laparoscopic ultrasound has led to rapid intraoperative imaging of the extrahepatic biliary tree. The long-term results of laparoscopic bile duct injuries have been better defined during the past several years. Finally, the role of surgical resection for gallbladder cancer detected during or after laparoscopic cholecystectomy has recently been evaluated.

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“…More recently spiral CT scanning has been used in conjunction with intravenous cholangiography (CT-IVC) to produce axial and three-dimensional images [11][12][13][14][15][16], the renewed interest in intravenous cholangiography owing much to the advent of laparoscopic cholecystectomy [17][18][19][20][21][22][23]. Spiral CT has also been combined with oral iopanoic acid to display the bile ducts [24] and detect duct stones with one group reporting an 85 to 93% sensitivity [25].…”

Section: Introductionmentioning

confidence: 99%

Accuracy of computed tomographic intravenous cholangiography (CT-IVC) with iotroxate in the detection of choledocholithiasis

et al. 2004

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To determine the accuracy of computed tomographic intravenous cholangiography (CT-IVC) for detection of choledocholithiasis. Sixty-five patients undergoing endoscopic retrograde cholangiography (ERC) underwent CT-IVC prior to ERC, using a single detector helical CT following intravenous infusion of 100 ml iotroxate. Patients with bilirubin levels >3 times normal were excluded. ERC was indeterminate in three patients (4.7%) and CT-IVC in four (6.3%). Twenty-three patients had ductal calculi at ERC, and CT-IVC was positive in 22, with two false positives and one false negative: sensitivity 95.6%, specificity 94.3%. Stones were multiple in nine and solitary in 14. Of the 14 solitary stones, ten were

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Intravenous cholangiography before 1000 consecutive laparoscopic cholecystectomies

Abstract: Routine preoperative i.v.c., with reservation of intraoperative cholangiography for indeterminate i.v.c. examinations or the need for anatomical clarification, is a safe strategy for laparoscopic cholecystectomy.

Cited by 3 publications

References 15 publications

Five‐year Prospective Audit of Routine Intravenous Cholangiography and Selective Endoscopic Retrograde Cholangiography with or without Intraoperative Cholangiography in Patients Undergoing Laparoscopic Cholecystectomy

Five‐year Prospective Audit of Routine Intravenous Cholangiography and Selective Endoscopic Retrograde Cholangiography with or without Intraoperative Cholangiography in Patients Undergoing Laparoscopic Cholecystectomy

Biliary tract surgery

Accuracy of computed tomographic intravenous cholangiography (CT-IVC) with iotroxate in the detection of choledocholithiasis

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