Surgical management of benign lesions of the bile ducts

Improving the safety of laparoscopic cholecystectomy: the routine use of preoperative magnetic resonance cholangiography

“…The accuracy of MRC has improved as experience with the technique has grown and image quality has been refined [13,23,25,27,30]. However, the exact role of this method in the routine setting is still controversial.…”

Role of Selective Intra‐operative Cholangiography During Cholecystectomy

“…They justify their policy by reporting unsuspected choledocholithiasis in up to 5% of patients undergoing cholecystectomies 10,11 and a higher incidence of CBD injury. 12,13 Since all patients in the present study were subjected to open cholecystectomy we cannot address the issue of CBD injury during laparoscopic cholecystectomy and will limit our discussion to the use of selective versus routine IOC.…”

Consequences of routine peroperative cholangiography during cholecystectomy for gallstone disease: A prospective, randomized study

“…The main argument in favor of always performing PC during cholecystectomy is the detection of asymptomatic choledocholithiasis. Depending on the technique of PC and on the indicators of CBD calculi used, unsuspected stones have been found in up to 7% of the patients [29], although most authors report considerably lower figures [3,12,14,22]. The clinical significance of such calculi is debated, however, since a large proportion probably pass spontaneously [12,15].…”

“…Such improvements may also significantly reduce the proportion of false-negative cholangiograms reported in up to 2.1% [14], and may reduce the number of nondiagnostic investigations. Interpretation of the cholangiograms in cooperation with a radiologist seems to increase the diagnostic accuracy [24,25,29].…”

“…The investigation seems to be contraindicated only in patients with infected bile, in whom PC without manometric control may increase the incidence of bacteremia [53]. Many authors maintain that there are no complications associated with PC [6,7,29,54]; however, this assumption is based on results from studies that do not include comparable treatment groups. In the present investigation there was a significantly increased rate of postoperative complications in the PC group.…”