TECHNIQUE AND RESULTS OF ROUTINE DYNAMIC CHOLANGIOGRAPHY DURING 528 CONSECUTIVE LAPAROSCOPIC CHOLECYSTECTOMIES

With the advent of laparoscopic cholecystectomy a trend toward more ex tensive preoperative diagnostic study of the biliary tree by intraveno us cholangiography or ERCP has been observed. However, both exams have technical limitations and are not without risk. We report our experie nce with 500 consecutive routine dynamic intraoperative cholangiograph ies during laparoscopic cholecystectomy, 97% of which were successful. No lesions from cholangiography were observed. In ten patients clips on the cystic artery appeared on intraoperative cholangiogram to be to o close to the hepatic duct and were removed. Anomalies of surgical im portance were discovered in 11 patients (2.3%). Unsuspected stones wer e found in 18 cases (3.7%) and suspected stones confirmed in 12 (2.4%) . In our experience routine dynamic intraoperative cholangiography pro vided important information in 51 cases out of 500 (10.2%). We conclud e that routine dynamic intraoperative cholangiography is extremely use ful for safer laparoscopic cholecystectomy and cost containment.