Is intra-operative cholangiography necessary during laparoscopic cholecystectomy? A multicentre rural experience from a developing world country

Mir, Iqbal Saleem; Mohsin, Mir; Kirmani, Omar; Majid, Tafazul; Wani, Khurshid Alam; Hassan, M. T.; Naqshbandi, Javed; Maqbool, Mohammed

doi:10.3748/wjg.v13.i33.4493

Cited by 23 publications

(22 citation statements)

References 22 publications

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“…Other authors have reported similar series without IOC [15][16][17][38][39][40][41][42][43][44][45]. Our study included 2,714 cases, which, to our knowledge, represented the largest reported series of LC without IOC.…”

Section: Discussionmentioning

confidence: 79%

“…Another policy that has not been discussed enough in the literature is performing LC without resorting to IOC. Due to different reasons such as financial constraints, disadvantages of IOC, and doubt of some authors about its advantages, many centers are currently performing LC without IOC, provided that every effort is done preoperatively to find those patients who are more likely to harbor silent bile duct stones [15][16][17]. Those patients are directed to other therapeutic options such as preoperative endoscopic sphincterotomy and duct clearance before LC or single-stage cholecystectomy and bile duct exploration, whether open or laparoscopic.…”

Section: Introductionmentioning

confidence: 98%

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Major biliary complications in 2,714 cases of laparoscopic cholecystectomy without intraoperative cholangiography: a multicenter retrospective study

et al. 2011

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Section: Discussionmentioning

confidence: 79%

Section: Introductionmentioning

confidence: 98%

Major biliary complications in 2,714 cases of laparoscopic cholecystectomy without intraoperative cholangiography: a multicenter retrospective study

et al. 2011

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“…On the other hand, surgeons who adopt the selective implementation of IOC state that only one third of asymptomatic CBD stones need intervention [36]. In the scientific literature there are several articles that have reported a similar series without IOC [37][38][39][40][41].…”

Section: Discussionmentioning

confidence: 99%

Bile Duct Injury during Laparoscopic Cholecystectomy without Intraoperative Cholangiography: A Retrospective Study on 1,100 Selected Patients

Pesce

Portale²,

Minutolo³

et al. 2012

Dig Surg

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Background: Whether to routinely or selectively use intraoperative cholangiography (IOC) during laparoscopic cholecystectomy (LC) has been a controversial issue for many years. Many authors maintain that IOC decreases the rate of biliary complications such as bile duct injuries, biliary leak, and missed common bile duct (CBD) stones. However, in contrast to these claims, many centers have opted to perform LC without IOC. In this retrospective study, the results of a series of 1,100 LCs, all of which involved major biliary complications and which were performed without the use of IOC, were reviewed. Methods: Data from 1,100 selected patients (728 females and 372 males) undergoing LC without the use of IOC from January 2003 to November 2011 were analyzed. One hundred and seventy LCs were performed by young surgeons during the learning curve, and 930 by surgeons with over 10 years of experience. Two techniques were used to create pneumoperitoneum: the Veress technique in 319 cases (29%) and the Hasson technique in the remaining 781 cases (71%). Patients with a suspicion of CBD stones were excluded from the study. Results: Two CBD injuries (0.18%) and three biliary leaks (0.27%) were detected among this group. Thirty-three patients (3%) needed conversion to open cholecystectomy. Missed CBD stones were reported in 4 cases (0.36%). There was no postoperative mortality. Conclusion: LC can be performed safely without the use of IOC and with acceptable low rates of biliary complications. An accurate preoperative evaluation of clinical risk factors, precise operative procedures, and conversion to an open approach in doubtful cases are important measures which must be taken to prevent CBD injury.

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“…One cholecystohepatic duct was detected and managed intraoperatively, 1 patient had retained CBD stones, while 1 patient had retained cystic duct stones. Incidental gallbladder malignancy was detected in 2 cases [45].…”

Section: Intraoperative Cholangiogram (Ioc)mentioning

confidence: 99%

“…Mir et al [45] report on 1,267 patients (976 females/ 291 males) where laparoscopic cholecystectomy without routine IOC was performed. Twenty-three cases were converted to open procedures; 12 patients developed port site infection, and there was no procedure related mortality.…”

Section: Intraoperative Cholangiogram (Ioc)mentioning

confidence: 99%

Common bile duct stones — their presentation, diagnosis and management

Desai¹,

Shokouhi

2009

Indian J Surg

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Common bile duct (CBD) stones continue to pose a signifi cant problem both to the patient and the surgeon. They increase the morbidity of a patient undergoing Cholecystectomy from less than 5% to as much as 20% and almost zero mortality to as high as 30%. Recent times have thrown up a fair share of controversy in the management of this condition both due to technological innovations and costreduction-pressures. The aim in CBD stone disease, as in any benign disease is to discover a therapeutic algorithm with minimal morbidity, no mortality and at reasonable cost. This can be achieved only by a thorough understanding of the disease and also the available diagnostic and treatment modalities.This article dicusses the diagnosis, investigation and therapy of CBD stones and gives a therapeutic algorithm.

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Is intra-operative cholangiography necessary during laparoscopic cholecystectomy? A multicentre rural experience from a developing world country

Cited by 23 publications

References 22 publications

Major biliary complications in 2,714 cases of laparoscopic cholecystectomy without intraoperative cholangiography: a multicenter retrospective study

Major biliary complications in 2,714 cases of laparoscopic cholecystectomy without intraoperative cholangiography: a multicenter retrospective study

Bile Duct Injury during Laparoscopic Cholecystectomy without Intraoperative Cholangiography: A Retrospective Study on 1,100 Selected Patients

Common bile duct stones — their presentation, diagnosis and management

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