LAPAROSCOPIC CHOLECYSTECTOMY - CAN PREOPE RATIVE IV CHOLANGIOGRAPHY BE DISPENSED WITH

Since the introduction of laparoscopic cholecystectomy as method of ch oice for the treatment of gallstone disease, many authors have propose d a preoperative intravenous cholangiogram as an alternative to routin e intraoperative cholangiography. To assess the value of intravenous c holangiography we performed a prospective randomized study with 100 pa tients undergoing cholecystectomy for gallstone disease. Patients with predefined criteria indicating possible choledocholithiasis were excl uded. In none of the 50 performed i.v.-cholangiograms was evidence of a stone in the common bile duct or an anatomic variation of the biliar y tract found. There was no significant difference in regard to intra- and postoperative complications between the group with preoperative c holangiography and the group without intravenous cholangiogram. We con clude that there is no significant advantage in performing routine pre operative intravenous cholangiography, and recommend the selective use of intraoperative cholangiography.