Intraoperative cholangiography during elective laparoscopic cholecystectomy: selective or routine use?

Alex Augusto Silva, Carlos Augusto Canteras Raposo Camara, Aiodair Martins Júnior, Celso Júnior Oliveira Teles, Júverson Alves Terra Júnior, Eduardo Crema
2013 Acta Cirurgica Brasileira  
PURPOSE: To investigate clinical, laboratory and ultrasonographic parameters in patients with and without preoperative criteria for intraoperative cholangiography (IOC) during laparoscopic cholecystectomy in order to define predictive factors of choledocolithiasis. METHODS: As a criterion for inclusion in the study the patients should present chronic calculous cholecystitis in the presence or absence of any recent clinical, laboratory of ultrasonographic finding suggesting choledocolithiasis,
more » ... oledocolithiasis, who were therefore submitted to cholangiography during surgery. RESULTS: A total of 243 laparoscopic cholecystectomies with IOC were performed on patients with chronic calculous cholecystitis with or without a preoperative formal indication for contrast examination. Choledocolithiasis was detected in 33 (13.58%) of the 243 patients studied. The incidence of previously unsuspected choledocolithiasis was only one case (1.0%) among 100 patients without an indication for this exam. However, 32 (22.37%) cases of choledocolithiasis were observed among the 143 patients with a preoperative indication for IOC. CONCLUSION: The use of selective cholangiography is safe for the diagnosis of choledocolithiasis. Only 22.37% of the cholangiography results were positive in cases of suspected choledocolithiasis.
doi:10.1590/s0102-86502013001000009 pmid:24114304 fatcat:qkvzausujndwboklpbcqqwustq