Intraoperative cholangiography during elective laparoscopic cholecystectomy: selective or routine use?

Purpose: To investigate clinical, laboratory and ultrasonographic parameters in patients with and without preoperative criteria for intraoperative cholangiography (IOC) during laparoscopic cholecystectomy in order to define predictive factors of choledocolithiasis.

Methods: As a criterion for inclusion in the study the patients should present chronic calculous cholecystitis in the presence or absence of any recent clinical, laboratory of ultrasonographic finding suggesting choledocolithiasis, who were therefore submitted to cholangiography during surgery.

Results: A total of 243 laparoscopic cholecystectomies with IOC were performed on patients with chronic calculous cholecystitis with or without a preoperative formal indication for contrast examination.

Excluded-loop hepatojejunal anastomosis with use of laparoscopy in late management of iatrogenic ligature of the bile duct.

Although the procedures adopted for bile duct surgery are routine, serious complications occasionally occur. This article reports the authors' experience in managing an iatrogenic ligature of the bile duct. The patient in this case had undergone open cholecystectomy and had significant jaundice in the early postoperative period.