Role of routine intraoperative cholangiography during laparoscopic cholecystectomy

Abstract

In our study, we conclude that routine IOC was successful and safe, yields information that was not useful to alter operative management. The operating time was significantly longer but there was no significant difference in the hospital stay. Routine IOC decreases the readmission rate with post cholecystectomy syndrome, which occurs in 10-40% of the post cholecystectomy patients.

Role of Intraoperative Cholangiography in Laparoscopic Cholecystectomy in Higher Risk Patients of Bile Duct Injuries

“…Reports of timing for IOC vary based on technique, experience with the procedure, and setting [6] mentioned that IOC time ranged from 17 to 42min with mean time of 24.82min while in [7] IOC added an average of 28 minutes to total operative time. In [8] IOC time was just over 10 minutes, and in [9] IOC time ranged only from 2 to 16 minutes.…”

Can clinical factors predict the need for intervention after a positive intraoperative cholangiogram?

“…CBD stones are present in 10–15% of patients undergoing elective cholecystectomy . IOC is widely used to delineate biliary anatomy as well as to evaluate the presence of choledocholithiasis, with the intention of preventing serious complications including gallstone pancreatitis, acute cholangitis and biliary obstruction.…”

“…Evaluation of CBD stones during laparoscopic cholecystectomy CBD stones are present in 10-15% of patients undergoing elective cholecystectomy. [1][2][3] IOC is widely used to delineate biliary anatomy as well as to evaluate the presence of choledocholithiasis, with the intention of preventing serious complications including gallstone pancreatitis, acute cholangitis and biliary obstruction. However, the true incidence of complications due to retained stones remains unknown.…”

“…More importantly, some studies have suggested that it has a false‐positive rate of up to 50% for detecting stones . The clinical consequence of this current practice is that many unnecessary ERCP have been performed, with their own inherent risks including bleeding, perforation, pancreatitis and the complications of sedation …”

“…2 The clinical consequence of this current practice is that many unnecessary ERCP have been performed, with their own inherent risks including bleeding, perforation, pancreatitis and the complications of sedation. 3 Thus, it is imperative to identify clinical factors that may assist in determining which patients with a positive IOC are at an increased risk for harboring stones. The aim of this study was to determine whether clinical factors such as the elevation or decline of biochemical liver test parameters and bile duct dilation can help to identify patients who will truly benefit from therapeutic ERCP following positive IOC study.…”