Intraoperative cholangiography performed during laparoscopic cholecystectomy provides an exact picture of the biliary anatomy. It may prevent iatrogenic bile duct injury and detect unsuspected common duct stones. Laparoscopic cannulation of the cystic duct can be difficult and time-consuming. We therefore evaluated the simpler technique of cholecystocholangiography by direct puncture and filling of the gallbladder with contrast medium. This technique was compared with cystic duct cholangiography in a prospective controlled trial of 69 patients. Cystic duct cholangiography (n=38) showed significantly better results than cholecystocholangiography (n=31) with optimal visualization of the biliary tree in 29 cases (76%) and seven cases (22%), respectively. The failure rate was 8% and 52%, respectively. Delineation of the cystic duct junction is important in order to prevent bile duct injury. The anatomy in this region was clearly delineated in 34 cases (89.5%) using cystic duct cholangiography but only in 11 cases (35.5%) with cholecystocholangiography. Cystic duct cholangiography revealed unsuspected common duct stones in three cases; however, choledocholithiasis was missed by cholecystocholangiography in at least two patients. Cystic duct cholangiography is clearly the optimal technique. In situations of unclear anatomy in which safe dissection of the cystic duct is not possible, cholecystocholangiography remains a useful alternative.
This is a preview of subscription content, log in via an institution to check access.
Access this article Subscribe and saveSpringer+ Basic
€34.99 /Month
Price includes VAT (Germany)
Instant access to the full article PDF.
Similar content being viewed by others Explore related subjectsDiscover the latest articles and news from researchers in related subjects, suggested using machine learning. ReferencesBerci G, Sackier JM (1991) The Los Angeles experience with laparoscopic cholecystectomy. Am J Surg 161: 382–384
Brodish RJ, Fing AS (1992) Cholangiography and laparoscopic cholecystectomy: the SAGES opinion. Surg Endosc 6: 91
Calame A, Montant R (1954) La cholangiographie laparoscopique. Helv Chir Acta 21: 438–440
Cuschieri A, Dubois F, Mouiel J, Mouret P, Becker H, Buess G, Trede M, Troidl H (1991) The European experience with laparoscopic cholecystectomy. Am J Surg 161: 385–387
Dubois F, Berthelot G, Levard H (1989) Cholecystectomie par coelioscopie. Presse Med 18: 980–982
Flowers JL, Zucker KA, Graham SM, Scovill WA, Imbembo AL, Bailey RW (1992) Laparoscopic cholangiography: an update. Surg Endosc 6: 99
Klaiber C, Metzger A (1992) Manual der laparoskopischen Chirurgie. Huber Verlag, Bern
Royer M (1952) La colangiografia laparoscopia. El Ateno, Buenos Aires
Sackier JM, Berci G, Phillips E, Carrol B, Shapiro S, Paz-Partlow M (1991) The role of cholangiography in laparoscopic cholecystectomy. Arch Surg 126: 1021–1026
The Southern Surgeons Club (1991) A prospective analysis of 1518 laparoscopic cholecystectomies. New Engl J Med 324: 1073–1078
Department for Visceral and Transplantation Surgery, University of Bern, Inselspital, CH-3010, Bern, Switzerland
A. Glättli, A. Metzger, C. Seiler & H. U. Baer
Department of Surgery, Aarberg Hospital, CH-3270, Aarberg, Switzerland
C. Klaiber
Department of Surgery, The Queen Elizabeth Hospital, University of Adelaide, 5011, Adelaide, Australia
G. J. Maddern
Glättli, A., Metzger, A., Klaiber, C. et al. Cholecystocholangiography vs cystic duct cholangiography during laparoscopic cholecystectomy. Surg Endosc 8, 299–301 (1994). https://doi.org/10.1007/BF00590957
Received: 09 April 1993
Accepted: 27 July 1993
Issue Date: April 1994
DOI: https://doi.org/10.1007/BF00590957
RetroSearch is an open source project built by @garambo | Open a GitHub Issue
Search and Browse the WWW like it's 1997 | Search results from DuckDuckGo
HTML:
3.2
| Encoding:
UTF-8
| Version:
0.7.4