One Thousand and Six Consecutive Laparoscopic Intraoperative Cholangiograms

Intraoperative cholangiography was successfully performed in 1,000 out of 1,006 attempts in 1019 consecutive cholecystectomies. There were 783 chronic, 95 acute, 61 fibrotic, 27 gangrenous and 40 cases of hydrops of the gallbladder in those laparoscopic cholecystectomies performed. Unsuspected common duct stones were identified in 5% of the patients. There were no injuries resulting from intra-operative cholangiography performed via the cystic duct. In this large series, routine cholangiography was thought to be helpful in the prevention of common bile duct injuries and the establishment of abnormal anatomy. In non-acute cholecystitis, intraoperative cholangiography is necessary due to the importance of abnormal anatomy verification. The technique of laparoscopic cholecystectomy differs greatly from that of open technique, and, therefore, routine intraoperative cholangiography is strongly advised.