Systematic Intraoperative Cholangiography During Elective Laparoscopic Cholecystectomy: Is It a Justifiable Practice?

Overview

Journal Ann Hepatobiliary Pancreat Surg

Date 2023 Jan 18

PMID 36653318

Authors

Francesco Esposito

Iolanda Scoleri

Rafika Cattan

Marie Cecile Cook

Dorin Sacrieru

Nouredine Meziani

Marco Del Prete

Morad Kabbej

Affiliations

Soon will be listed here.

Abstract

Backgrounds/aims: Routine execution of intraoperative cholangiography (IOC) in laparoscopic cholecystectomy (LC) is considered a good practice to help early identification of biliary duct injuries (BDIs) or common bile duct (CBD) stones. This study aimed to determine the impact of IOC during LC.

Methods: This is a retrospective, monocentric study, including patients with a LC performed from January 2020 to December 2021.

Results: Of 303 patients, 215 (71.0%) were in the IOC group and 88 (29.0%) in the no-IOC group. IOC was incomplete or unclear in 10.7% of patients, with a failure rate of 14.7%. Operating time was 15 minutes longer in the IOC group ( = 0.01), and postoperative complications were higher (5.1% vs. 0.0%, = 0.03). There were three BDIs (0.99%), all included in the IOC group; only one was diagnosed intraoperatively, and the other two were identified during the postoperative course. Regarding identifying CBD stones, IOC showed a sensitivity of 77%, a specificity of 98%, an accuracy of 97.2%, a positive predictive value of 63% and a negative predictive value of 99%.

Conclusions: Systematic IOC has shown no specific benefits and prolonged operative duration. IOC should be performed on selected patients or in situations of uncertainty on the anatomy.

Citing Articles

The Use of Intraoperative Cholangiography During Cholecystectomy: A Systematic Review.

Osailan S, Esailan M, Alraddadi A, Almutairi F, Sayedalamin Z Cureus. 2023; 15(10):e47646.

PMID: 37899894 PMC: 10612988. DOI: 10.7759/cureus.47646.

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