Background: In 100 consecutive patients who underwent laparoscopic cho
lecystectomy, the feasibility, reliability, and cost of routine laparo
scopic cholangiography were prospectively studied. Methods: Fluoroscop
ic cholangiograms with multiple exposures were successfully completed
in all patients in an average time of 6.9 min. Results: Twenty-one per
cent were abnormal, and 15 common duct stones and 6 significant anatom
ic anomalies detected. Thirteen out of 15 patients with common duct st
ones had preoperative suspicion of common duct stones. Two out of 15 w
ere completely unsuspected. The average cost of cholangiography was $7
68, and there were no complications related to the procedure. There we
re no false interpretations, Conclusions: When compared with selective
preoperative endoscopic retrograde cholangiopancreatography (ERCP), r
outine laparoscopic cholangiography is safer, more accurate, and less
costly, and may have the added benefit of potentially reducing iatroge
nic injuries in patients with anatomic variations, Routine laparoscopi
c cholangiography should be considered by all surgeons.