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. 1994 Jul;35(7):991–995. doi: 10.1136/gut.35.7.991

Imaging of the common bile duct in patients undergoing laparoscopic cholecystectomy.

P J Hainsworth 1, M Rhodes 1, R H Gompertz 1, C P Armstrong 1, T W Lennard 1
PMCID: PMC1374850  PMID: 8063230

Abstract

Options for managing the common bile duct during laparoscopic cholecystectomy include routine peroperative cholangiography and selected preoperative endoscopic retrograde cholangiopancreatography (ERCP). The use of these methods was reviewed in 350 patients with symptomatic gall stones referred for laparoscopic cholecystectomy. Unit A (n = 114) performed routine cystic duct cholangiography but undertook preoperative ERCP in patients at very high risk of duct stones only; unit B (n = 236) performed selected preoperative ERCP on the basis of known risk factors for duct stones. The detection rate for common bile duct stones was similar for units A and B (16% v 20%). In unit A, five of seven patients who had preoperative ERCP had duct stones. Operative cholangiography was technically successful in 90% of patients and duct stones were confidently identified in 13, one of whom went on to immediate open duct exploration. Postoperative ERCP identified duct stones in only four patients, indicating spontaneous passage in eight. In unit B, preoperative ERCP was undertaken in 76 of 236 (32%) patients and duct stones were identified in 47 (20%). Duct clearance was successful in 42 (18%) but failed in five (2%), necessitating elective open duct exploration. Both protocols for imaging the common bile duct worked well and yielded satisfactory short term results.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Acosta J. M., Ledesma C. L. Gallstone migration as a cause of acute pancreatitis. N Engl J Med. 1974 Feb 28;290(9):484–487. doi: 10.1056/NEJM197402282900904. [DOI] [PubMed] [Google Scholar]
  2. Alinder G., Nilsson U., Lunderquist A., Herlin P., Holmin T. Pre-operative infusion cholangiography compared to routine operative cholangiography at elective cholecystectomy. Br J Surg. 1986 May;73(5):383–387. doi: 10.1002/bjs.1800730524. [DOI] [PubMed] [Google Scholar]
  3. Andrén-Sandberg A., Alinder G., Bengmark S. Accidental lesions of the common bile duct at cholecystectomy. Pre- and perioperative factors of importance. Ann Surg. 1985 Mar;201(3):328–332. [PMC free article] [PubMed] [Google Scholar]
  4. Bailey R. W., Zucker K. A., Flowers J. L., Scovill W. A., Graham S. M., Imbembo A. L. Laparoscopic cholecystectomy. Experience with 375 consecutive patients. Ann Surg. 1991 Oct;214(4):531–541. doi: 10.1097/00000658-199110000-00017. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Berci G., Sackier J. M., Paz-Partlow M. Routine or selected intraoperative cholangiography during laparoscopic cholecystectomy? Am J Surg. 1991 Mar;161(3):355–360. doi: 10.1016/0002-9610(91)90597-7. [DOI] [PubMed] [Google Scholar]
  6. Cahill C. J., Pain J. A. Current practice in biliary surgery. Br J Surg. 1988 Dec;75(12):1169–1172. doi: 10.1002/bjs.1800751208. [DOI] [PubMed] [Google Scholar]
  7. Cantwell D. V. Routine cholangiography during laparoscopic cholecystectomy. Arch Surg. 1992 Apr;127(4):483–484. doi: 10.1001/archsurg.1992.01420040129023. [DOI] [PubMed] [Google Scholar]
  8. Corder A. P., Scott S. D., Johnson C. D. Place of routine operative cholangiography at cholecystectomy. Br J Surg. 1992 Sep;79(9):945–947. doi: 10.1002/bjs.1800790931. [DOI] [PubMed] [Google Scholar]
  9. Daly J., Fitzgerald T., Simpson C. J. Pre-operative intravenous cholangiography as an alternative to routine operative cholangiography in elective cholecystectomy. Clin Radiol. 1987 Mar;38(2):161–163. doi: 10.1016/s0009-9260(87)80020-x. [DOI] [PubMed] [Google Scholar]
  10. Davidoff A. M., Pappas T. N., Murray E. A., Hilleren D. J., Johnson R. D., Baker M. E., Newman G. E., Cotton P. B., Meyers W. C. Mechanisms of major biliary injury during laparoscopic cholecystectomy. Ann Surg. 1992 Mar;215(3):196–202. doi: 10.1097/00000658-199203000-00002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. DenBesten L., Berci G. The current status of biliary tract surgery: an international study of 1072 consecutive patients. World J Surg. 1986 Feb;10(1):116–122. doi: 10.1007/BF01656101. [DOI] [PubMed] [Google Scholar]
  12. Deziel D. J., Millikan K. W., Economou S. G., Doolas A., Ko S. T., Airan M. C. Complications of laparoscopic cholecystectomy: a national survey of 4,292 hospitals and an analysis of 77,604 cases. Am J Surg. 1993 Jan;165(1):9–14. doi: 10.1016/s0002-9610(05)80397-6. [DOI] [PubMed] [Google Scholar]
  13. Flowers J. L., Zucker K. A., Graham S. M., Scovill W. A., Imbembo A. L., Bailey R. W. Laparoscopic cholangiography. Results and indications. Ann Surg. 1992 Mar;215(3):209–216. doi: 10.1097/00000658-199203000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Gerber A. A requiem for the routine operative cholangiogram. Surg Gynecol Obstet. 1986 Oct;163(4):363–364. [PubMed] [Google Scholar]
  15. Gompertz R. H., Rhodes M., Lennard T. W. Laparoscopic cholangiography: an effective and inexpensive technique. Br J Surg. 1992 Mar;79(3):233–234. doi: 10.1002/bjs.1800790315. [DOI] [PubMed] [Google Scholar]
  16. Grace P. A., Qureshi A., Burke P., Leahy A., Brindley N., Osborne H., Lane B., Broe P., Bouchier-Hayes D. Selective cholangiography in laparoscopic cholecystectomy. Br J Surg. 1993 Feb;80(2):244–246. doi: 10.1002/bjs.1800800243. [DOI] [PubMed] [Google Scholar]
  17. Hunter J. G. Avoidance of bile duct injury during laparoscopic cholecystectomy. Am J Surg. 1991 Jul;162(1):71–76. doi: 10.1016/0002-9610(91)90207-t. [DOI] [PubMed] [Google Scholar]
  18. Johnson A. G., Hosking S. W. Appraisal of the management of bile duct stones. Br J Surg. 1987 Jul;74(7):555–560. doi: 10.1002/bjs.1800740703. [DOI] [PubMed] [Google Scholar]
  19. Kakos G. S., Tompkins R. K., Turnipseed W., Zollinger R. M. Operative cholangiography during routine cholecystectomy: a review of 3,012 cases. Arch Surg. 1972 Apr;104(4):484–488. doi: 10.1001/archsurg.1972.04180040098017. [DOI] [PubMed] [Google Scholar]
  20. Kelly T. R. Gallstone pancreatitis: pathophysiology. Surgery. 1976 Oct;80(4):488–492. [PubMed] [Google Scholar]
  21. Macintyre I. M., Wilson R. G. Impact of laparoscopic cholecystectomy in the UK: a survey of consultants. Br J Surg. 1993 Mar;80(3):346–346. doi: 10.1002/bjs.1800800327. [DOI] [PubMed] [Google Scholar]
  22. Macintyre I. M., Wilson R. G. Laparoscopic cholecystectomy. Br J Surg. 1993 May;80(5):552–559. doi: 10.1002/bjs.1800800505. [DOI] [PubMed] [Google Scholar]
  23. McEntee G., Grace P. A., Bouchier-Hayes D. Laparoscopic cholecystectomy and the common bile duct. Br J Surg. 1991 Apr;78(4):385–386. doi: 10.1002/bjs.1800780402. [DOI] [PubMed] [Google Scholar]
  24. Moossa A. R., Easter D. W., Van Sonnenberg E., Casola G., D'Agostino H. Laparoscopic injuries to the bile duct. A cause for concern. Ann Surg. 1992 Mar;215(3):203–208. doi: 10.1097/00000658-199203000-00003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Nathanson L. K., Shimi S., Cuschieri A. Laparoscopic cholecystectomy: the Dundee technique. Br J Surg. 1991 Feb;78(2):155–159. doi: 10.1002/bjs.1800780208. [DOI] [PubMed] [Google Scholar]
  27. Pace B. W., Cosgrove J., Breuer B., Margolis I. B. Intraoperative cholangiography revisited. Arch Surg. 1992 Apr;127(4):448–450. doi: 10.1001/archsurg.1992.01420040094016. [DOI] [PubMed] [Google Scholar]
  28. Pernthaler H., Sandbichler P., Schmid T., Margreiter R. Operative cholangiography in elective cholecystectomy. Br J Surg. 1990 Apr;77(4):399–400. doi: 10.1002/bjs.1800770414. [DOI] [PubMed] [Google Scholar]
  29. Phillips E. H. Routine versus selective intraoperative cholangiography. Am J Surg. 1993 Apr;165(4):505–507. doi: 10.1016/s0002-9610(05)80950-x. [DOI] [PubMed] [Google Scholar]
  30. Scott-Coombes D., Thompson J. N. Bile duct stones and laparoscopic cholecystectomy. BMJ. 1991 Nov 23;303(6813):1281–1282. doi: 10.1136/bmj.303.6813.1281. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Shively E. H., Wieman T. J., Adams A. L., Romines R. B., Garrison R. N. Operative cholangiography. Am J Surg. 1990 Apr;159(4):380–385. doi: 10.1016/s0002-9610(05)81276-0. [DOI] [PubMed] [Google Scholar]
  32. Thurston O. G., McDougall R. M. The effect of hepatic bile on retained common duct stones. Surg Gynecol Obstet. 1976 Oct;143(4):625–627. [PubMed] [Google Scholar]
  33. Vaira D., D'Anna L., Ainley C., Dowsett J., Williams S., Baillie J., Cairns S., Croker J., Salmon P., Cotton P. Endoscopic sphincterotomy in 1000 consecutive patients. Lancet. 1989 Aug 19;2(8660):431–434. doi: 10.1016/s0140-6736(89)90602-8. [DOI] [PubMed] [Google Scholar]
  34. Voyles C. R., Petro A. B., Meena A. L., Haick A. J., Koury A. M. A practical approach to laparoscopic cholecystectomy. Am J Surg. 1991 Mar;161(3):365–370. doi: 10.1016/0002-9610(91)90599-9. [DOI] [PubMed] [Google Scholar]
  35. Yip A. W., Ng W. S., Chow W. C., Choi T. K., Lam K. H. Plea for selective operative cholangiography. J R Coll Surg Edinb. 1991 Feb;36(1):21–24. [PubMed] [Google Scholar]

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