OPERATIVE CHOLANGIOGRAPHY IN THE LAPAROSCOPIC ERA: A RETROSPECTIVE REVIEW OF THE QUALITY AND INTERPRETATION OF THIS INVESTIGATION


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Abstract

Background:Operative cholangiograms during the year of introduction of laparoscopic cholecystectomy were reviewed to examine their quality and interpretation.Methods:149 operative cholangiogram films (34 open and 115 laparoscopic) were reviewed retrospectively by a panel and scored for their ability to demonstrate biliary anatomy and detect bile duct stones.Results:Cholangiography performed by the cystic duct was of similar quality, whether performed laparoscopically or open. Cholangiography via the cystic duct (conventional films) produces superior results for both anatomical delineation and detection of choledocholithiasis (80% adequate) than cholangiography performed by direct gallbladder puncture (29-35% adequate).Conclusion:There is no clear evidence to suggest that an intra-operative specialist radiological review of cholangiograms performed by the cystic duct would improve the detection of bile duct stones.

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