Selective vs routine use of intraoperative cholangiography. An argument.

Publication/Presentation Date

9-1-1989

Abstract

We reviewed the course of 314 patients who underwent cholecystectomy at a University Hospital in 1985. Two hundred eighty-five patients underwent cholecystectomy for cholelithiasis. Preoperatively elevated liver function test results, history of jaundice or pancreatitis, or operative findings of palpable common bile duct stone or dilated extrahepatic ducts were criteria for indicated cholangiography. Of 142 patients who had cholangiography with negative results, only 31 were indicated by these criteria. In 93 patients not having cholangiography performed, the criteria were met in only 8 patients. Of 38 patients who underwent common bile duct exploration, only 29 had stones. As operative time, morbidity, and cost were demonstrably increased in patients undergoing cholangiography, a selective approach is advocated. The number of unnecessary common bile duct explorations might be cut by almost half, while the incidence of finding clinically unsuspected yet significant common bile duct stones is negligible.

Volume

124

Issue

9

First Page

1041

Last Page

1042

ISSN

0004-0010

Disciplines

Medicine and Health Sciences | Other Medical Specialties | Surgery

PubMedID

2774904

Department(s)

Department of Surgery, Department of Surgery Faculty

Document Type

Article

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