The role of cholangiography in laparoscopic cholecystectomy
J. M. Sackier, G. Berci, E. Phillips, B. Carroll, S. Shapiro and M. Paz-Partlow
Department of Surgery, Cedars Sinai Medical Center, Los Angeles, Calif 90048.
Cholangiography is not routinely performed in open surgery, but there are
reasons why it should be in laparoscopic cholecystectomy. These include
finding common duct stones, identifying the cystic-common duct junction,
and noting an inadvertent injury. Thirty-six (7.0%) of 516 laparoscopic
cholecystectomies were converted to open surgery; 24 before attempting
cholangiography and 12 based on roentgenographic findings. In 73 patients
(14.1%), cholangiography showed abnormal findings. Common duct injury was
identified in one patient and common duct stones were found in 35.
Twenty-one patients were treated laparoscopically and eight underwent open
choledocholithotomy. In 22 patients, a short cystic duct was seen that
might otherwise have been overlooked, and possible injury was avoided.
Cholangiography should be attempted routinely, so that in cases with
abnormal findings, open cholecystectomy may be considered.
