ROUTINE OPERATIVE CHOLANGIOGRAPHY DURING LAPAROSCOPIC CHOLECYSTECTOMY- FEASIBILITY AND VALUE IN 107 PATIENTS

OBJECTIVE. Laparoscopic cholecystectomy is becoming a popular alternat ive to open cholecystectomy. However, the technical aspects of this ne w procedure increase the risk of injuring the bile ducts. The purpose of this study was to determine the feasibility and value of performing cholangiography during laparoscopic cholecystectomy. MATERIALS AND ME THODS. We retrospectively reviewed the clinical and operative cholangi ographic findings of the first 107 patients undergoing laparoscopic ch olecystectomy at Hotel-Dieu de Montreal between August 1990 and August 1991. RESULTS. Operative cholangiography was attempted in 98% of pati ents; the success rate was 71%. Eight anatomic anomalies of the biliar y tract that were of surgical importance were found as well as 10 case s of stones in the common bile duct, eight of which were unsuspected. No biliary tract injuries occurred. With experience, surgical cannulat ion of the cystic duct for injection of contrast material can be done quickly without major difficulty, and cholangiograms of excellent diag nostic quality can be obtained. CONCLUSION. Our results show that oper ative cholangiography is feasible and useful in patients undergoing la paroscopic cholecystectomy.