Abstract
Background
Intraoperative cholangiography (IOC) is frequently omitted in patients undergoing laparoscopic cholecystectomy (LC) if they have had successful preoperative endoscopic retrograde cholangiography (ERC).
Methods
A prospectively maintained divisional laparoscopic cholecystectomy database was searched from 1991 to 1997 for patients who had IOC after preoperative ERC. The presence of recurrent or residual common duct stones seen on IOC and their impact on subsequent management were evaluated.
Results
We identified a group of 127 patients who underwent preoperative ERC. Thirty-one patients (31/127, or 24%) went on to receive an IOC during cholecystectomy. In 15 patients whose preoperative ERC was reported normal, five (33%) had an abnormal IOC. In 16 patients whose ERC was reported as having cleared the duct, eight (50%) had an IOC abnormality. Eight of these 31 patients required a further procedure to clear the duct.
Conclusion
Retained or recurrent common duct stones at cholecystectomy following diagnostic or therapeutic ERC were more common than expected. Therefore, IOC is recommended during LC regardless of the findings yielded by the preoperative ERC.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Bergamaschi R, Tuech JJ, Braconier L, Walsoe HK, Marvik R, Boyet J, Arnaud JP (1999) Selective endoscopic retrograde cholangiography prior to laparoscopic cholecystectomy for gallstones. Am J Surg 178: 46–49
Bergman JJ, van der Mey S, Rauws EA, Tijssen JG, Gouma DJ, Tytgat GN, Huibregtse K (1996) Long-term follow-up after endoscopic sphincterotomy for bile duct stones in patients younger than 60 years of age. Gastrointest Endosc 44: 643–649
Coppola R, D’Ugo D, Ciletti S, Riccioni ME, Cosentino L, Magistrelli P, Picciocchi, A (1996) ERCP in the era of laparoscopic biliary surgery: experience with 407 patients. Surg Endosc 10: 403–406
Coppola R, Riccioni ME, Ciletti S, Cosentino L, Coco C, Magistrelli P, Picciocchi A (1997) Analysis of complications of endoscopic sphincterotomy for biliary stones in a consecutive series of 546 patients. Surg Endosc 11: 129–132
Cotton PB (1993) Endoscopic retrograde cholangiopancreatography and laparoscopic cholecystectomy. Am J Surg 165: 474–478
Cuschieri A, Croce E, Faggioni A, Jakimowicz J, Lacy A, Lezoche E, Morino M, Ribeiro VM, Toouli J, Visa, J (1996) EAES ductal stone study: preliminary findings of multicenter prospective randomized trial comparing two-stage vs single-stage management. Surg Endosc 10: 1130–1135
Kum CK, Goh PM (1996) Preoperative ERCP in the management of common bile duct stones before laparoscopic cholecystectomy. Eur J Surg 162: 205–210
Memon MA, Hassaballa H, Memon MI (2000) Laparoscopic common bile duct exploration: the past, the present, and the future. Am J Surg 179: 309–315
Sarli L, Pietra N, Franze A, Colla G, Costi R, Gobbi S, Trivelli M (1999) Routine intravenous cholangiography, selective ERCP, and endoscopic treatment of bile duct stones before laparoscopic cholecystectomy. Gastrointest Endosc 50: 200–208
Schmitt CM, Baillie J, Cotton PB (1995) ERCP following laparoscopic cholecystectomy: a safe and effective way to manage CBD stones and complications. HPB Surg 8: 187–192
Urbach DR, Khajanchee YS, Jobe BA, Standage BA, Hansen PD, Swanstrom LL (2001) Cost-effective management of common bile duct stones: a decision analysis of the use of endoscopic retrograde cholangiopancreatography (ERCP), intraoperative cholangiography, and laparoscopic bile duct exploration. Surg Endosc 15: 4–13
Author information
Authors and Affiliations
Additional information
Online publication: 8 February 2002
Rights and permissions
About this article
Cite this article
Edye, M., Dalvi, A., Canin-Endres, J. et al. Intraoperative cholangiography is still indicated after preoperative endoscopic cholangiography for gallstone disease. Surg Endosc 16, 799–802 (2002). https://doi.org/10.1007/s00464-001-8244-1
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s00464-001-8244-1