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Jonathan M. Sackier, MD, FRCS; George Berci, MD, FACS; Edward Phillips, MD, FACS; Brendon Carroll, MD, FACS; Stephen Shapiro, MD, FACS; Margaret Paz-Partlow, MFA

Arch Surg. 1991;126(8):1021-1026.

Abstract
• 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.

(Arch Surg. 1991;126:1021-1026)

Author Affiliations
From the Department of Surgery, Cedars Sinai Medical Center, Los Angeles, Calif.

Footnotes
Accepted for publication April 28, 1991.

Read before the 98th Annual Meeting of the Western Surgical Association, Scottsdale, Ariz, November 14, 1990.

Reprint requests to Department of Surgery, Cedars Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048 (Dr Sackier).

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