INTRA-OPERATIVE CHOLANGIOGRAPHY DURING LAPAROSCOPIC CHOLECYSTECTOMY. IS IT ESSENTIAL? | ||||
| The Egyptian Journal of Surgery | ||||
| Article 4, Volume 30, Issue 1, January 2011, Page 19-23 PDF (909.35 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejsur.2011.367531 | ||||
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| Authors | ||||
| Samy Saad; Alaa El Ashry* ; Usama Al Attar | ||||
| General Surgery Department, Ain Shams University, Egypt | ||||
| Abstract | ||||
| Aim: The aim of this work is to assess the value of using intraoperative cholangiogram during laparoscopic cholecystectomy. Methods: Thirty patients scheduled for laparoscopic cholecystectomy were subjected to intraoperative cholangiogram in the period between June 2006 and June 2009. Results: Four (13%) cholangiograms revealed short wide cystic ducts. Three (10%) cholangiograms revealed stones in the CBD. One of them was totally unsuspected preoperatively. The remaining two patients had mild elevation of liver enzymes preoperatively, without any clinical evidence. The operative time for the cholangiography procedure was 25 (15-40) minutes. Conclusions: Despite the increased operative time in using intraoperative cholangiogram, it helps to identify abnormal anatomy especially in difficult cases, avoid leaving an excessive length of the cystic duct stump and detect unsuspected biliary duct stones. Intraoperative cholangiogram is recommended especially in difficult cases and with unclear anatomy. Surgeons should train themselves to use operative cholangiography to the point of perfection and should have a low threshold for performing it to define ductal anatomy. | ||||
| Keywords | ||||
| Laparoscopy; Biliary tract; Choledocholithiasis | ||||
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