Operative cholangiography during laparoscopic cholecystectomy: considerations about routine or selective policy

Pisano, Giuseppe and Licheri, Sergio and Dazzi, Claudio and Erdas, Enrico and Pomata, Mariano and Daniele, Giovanni Maria (2005) Operative cholangiography during laparoscopic cholecystectomy: considerations about routine or selective policy. Il giornale di chirurgia, 26 (8/9). pp. 333-337. ISSN 1971-145x

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Abstract

Operative cholangiography (OC) during laparoscopic cholecystectomy (LC) is still a matter of debate regarding its routine or selective use. The present report is based upon a series of 30 selective cholangiographies performed in 290 LC during the years 1999-2004. Indications to OC were decided according to clinical data, liver chemistries, ultrasonographic (US) and intraoperative findings. In cases of unequivocal common bile duct (CBD) stones, a preoperative ERCP was performed and OC was not applied to confirm clearing of the biliary tract. OC was successful in 26 cases (86,6%): in 18 cases a normal cholangiogram was obtained and in 3 cases stones were detected into CBD. These patients underwent a postoperative successful ERCP at a variable interval of time. In 4 cases cholangiograms showed a delayed transit and in a single case a lack of contrast into the duodenum. Such occurrence was due to morphine derivatives employed during anesthesia. The Authors evaluate advantages and drawbacks of routine and selective OC according to personal and other Authors experience. Decision on selective or routine policy should be taken according to each surgeon experience and local facilities. Each laparoscopic surgeon must be able to perform and interpret an OC, specially if he has in mind to develop competence in laparoscopic CBD exploration.

Item Type:	Article
Additional Information:	Operative cholangiography, Laparoscopic cholecystectomy, Biliary injuries
Subjects:	600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 617 Rami vari della medicina; Chirurgia
Depositing User:	Chiara D'Arpa
Date Deposited:	18 Nov 2013 13:48
Last Modified:	18 Nov 2013 13:48
URI:	http://eprints.bice.rm.cnr.it/id/eprint/7502

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