Published online Sep 15, 2000. doi: 10.3748/wjg.v6.iSuppl3.33
Revised: April 6, 2000
Accepted: May 10, 2000
Published online: September 15, 2000
AIM: To evaluate the role of intraoperative cholangiogram (IOC) in preventing biliary duct injury during laparoscopic cholecystectomy.
METHODS: Injury location, mechanism, time of detection, treatment outcome, and whether an intraoperative cholangiogram was performed were evaluated in 31 cases of bile duct injuries.
RESULTS: Cholangiograms were done in 22 cases, but they were misinterpreted in 3 of them. In 12 of 19 misidentified cases, the cholangiogram was interpreted correctly, and the injury detected intraoperatively. Primary laparoscopic repair or open repair and T tube drainage solved the problem. No long-term complications occurred. However, in 3 of the 19 cases the cholangiogram was misinterpreted and in 4 of the 19 cases no cholangiogram was performed. Three of the seven patients required a cholangioenteric anastomosis. In 2 cases the diagnosis was delayed and one of these required a two-stage procedure. Morbidity was increased. Three cases of clim impingement of the common duct had delayed diagnoses, and two of them had injuries. Thermal injury developed in 4 cases who had cholangiograms.
CONCLUSION: Routine IOC plays no role in inducing, preventing, detecting, or minimizing any of the injuries due to clips, lacerations, or electrocautery. IOC does not prevent injuries due to duct misidentification either. Careful interpretation of IOC would prevent injuries and avoid an open operation.
- Citation: Li LB, Cai XJ, Li JD, Mu YP, Wang YD, Yuan XM, Wang XF, Bryner U, Jr RKF. Will intraoperative cholangiography prevent biliary duct injury in laparoscopic cholecystectomy. World J Gastroenterol 2000; 6(Suppl3): 33-33
- URL: https://www.wjgnet.com/1007-9327/full/v6/iSuppl3/33.htm
- DOI: https://dx.doi.org/10.3748/wjg.v6.iSuppl3.33
E- Editor: Hu S