Jc. Patel et al., THE ROLE OF INTRAVENOUS CHOLANGIOGRAPHY IN PREOPERATIVE ASSESSMENT FOR LAPAROSCOPIC CHOLECYSTECTOMY, British journal of radiology, 66(792), 1993, pp. 1125-1127
With the advent of laparoscopic cholecystectomy, pre-operative identif
ication of calculi in the common bile duct has become increasingly imp
ortant. In patients without clinical or biochemical evidence of common
bile duct calculi, debate continues as to the value of intravenous ch
olangiography (IVC) as a screening modality for the detection of unsus
pected choledocholithiasis. In a prospective series of 180 patients, I
VC was used to assess the common bile duct in 113 patients at low risk
of choledocholithiasis, 51 patients at high risk underwent endoscopic
retrograde cholangiography (ERC) and sphincterotomy if indicated, and
in 16 patients, for a variety of reasons, no pre-operative cholangiog
raphy was performed. 31% of those who had ERC and two (1.8%) of those
who had IVC had duct calculi. These data do not support the routine us
e of IVC in patients with no evidence of common bile duct calculi and
its routine use has been discontinued.