PREOPERATIVE DIAGNOSTIC PROCEDURE PRIOR T O LAPAROSCOPIC CHOLECYSTECTOMY - IS THERE AN INDICATION FOR IV CHOLANGIOGRAPHY

In a retrospective study including 163 patients we investigated the ne cessity of i.v. cholangiography in preoperative routine diagnostic wor kup prior to laparoscopic cholecystectomy. We evaluated the evidence o f i.v. cholangiography concerning the anatomy of the biliary system, t he evidence of common bile duct or cystic duct stones and the influenc e on the further therapeutic procedure. While the common bile duct cou ld be demonstrated in 96.3%, the cystic duct could be visualized in on ly 54.6%. One out of two patients with a short cystic duct was identif ied. Stones in the gallbladder were recognized in 72.4% of cases, whil e only two out of three patients with common bile duct stones were dia gnosed, In nine cases a deep junction of the cystic duct was found, bu t there was no influence on further operative procedure. Thus we found no improvement after routine use of i.v. cholangiography concerning t he evidence of common bile duct stones or avoidance of intraoperative lesions of the common bile duct. The routine use of i.v. cholangiograp hy prior to laparoscopic cholecystectomy is therefore not justified.