FINAL SCORE IN LAPAROSCOPIC CHOLECYSTECTOMY - CHOLANGIOGRAM-1207, NO CHOLANGIOGRAM-116

Background: The role of intraoperative fluorocholangiography (IOC) in laparoscopic cholecystectomy (LC) is controversial. We evaluated the u se of IOC at an institution where the study is performed routinely. Me thods: Records of all patients undergoing LC during a 3-year period en ding January 1, 1996 were reviewed. Results: A total of 1207 patients received IOC, whereas 116 patients did not. IOC findings were categori zed as follows: normal, 1016 cases (84%); CBD stone, 149 cases (12.3%) ; anomalies, 23 cases (1.9%); duodenal diverticula, 10 cases (0.8%); d uctal strictures, four cases (0.3%); and CBD diverticula, 5 cases (0.4 %). In the 116 patients who did not receive IOC, 35 of the procedures could not be performed, whereas 81 were not attempted. Of the 149 IOC that showed CBD stones, two were false positives. Anomalies included a ccessory right hepatic ducts (11 cases), cystic ducts joining the righ t hepatic duct (seven cases), and abnormal cystic duct entries (five c ases). Duct injuries occurred in 5 cases (0.4%), three before and two after IOC. Four injuries were minor; IOC prevented CBD transection. Co nclusions: Routine IOC is feasible, safe, accurate, and provides criti cal information of immediate use during LC. By treating ductal stones at operation and identifying patients without CBD stones, IOC minimize s need for postoperative studies, including endoscopic retrograde chol angiography (ERC).