Is ERCP necessary in all patients with an abnormal intraoperative cholangiogram?

2007 ◽  
Vol 4 (1) ◽  
pp. 20-21
Author(s):  
Bruce V MacFadyen ◽  
Michael A Edwards
Keyword(s):  
Intraoperative Cholangiogram

An Abnormal Intraoperative Cholangiogram

JAMA Surgery ◽  
2015 ◽  
Vol 150 (10) ◽  
pp. 1009
Author(s):  
Antonio Navarro-Sánchez ◽  
Hutan Ashrafian ◽  
Alberto Martínez-Isla
Keyword(s):  
Intraoperative Cholangiogram

scholarly journals Biliary Leak Rates After Cholecystectomy and Intraoperative Cholangiogram in Surgical Residency

2015 ◽  
Vol 180 (5) ◽  
pp. 565-569 ◽  
Author(s):  
Robert R. Shawhan ◽  
C. Rees Porta ◽  
Jason R. Bingham ◽  
Derek P. McVay ◽  
Daniel W. Nelson ◽  
...  
Keyword(s):  
Biliary Leak ◽  
Surgical Residency ◽  
Intraoperative Cholangiogram

Analysis of Endoscopic Retrograde Cholangiopancreatography after Positive Intraoperative Cholangiogram: Is it Necessary?

2016 ◽  
Vol 82 (10) ◽  
pp. 985-988
Author(s):  
John V. Gahagan ◽  
Steven Maximus ◽  
Matthew D. Whealon ◽  
Michael J. Phelan ◽  
Aram Demirjian ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Acute Cholecystitis ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Nationwide Inpatient Sample ◽  
Bile Duct Stone ◽  
Stone Extraction ◽  
Endoscopic Retrograde ◽  
Intraoperative Cholangiogram ◽  
Nationwide Inpatient Sample Database

The necessity of routine endoscopic retrograde cholangiopancreatography (ERCP) after positive intraoperative cholangiogram (IOC) during laparoscopic cholecystectomy is not well defined. We aimed to examine the incidence of positive IOC among patients who undergo IOC during cholecystectomy and the rate of subsequent ERCP stone extraction. The Nationwide Inpatient Sample database was reviewed for all patients undergoing cholecystectomy with IOC from 2002 to 2012. Patients were then analyzed for ERCP and stone extraction. A total of 73,508 patients who underwent cholecystectomy with IOC for a diagnosis of acute cholecystitis and found to have a bile duct stone were identified. Of these patients, 5915 underwent subsequent ERCP. In the patients that underwent subsequent ERCP, 1478 had a documented stone extraction during ERCP. The rate of stone extraction in the ERCP subset is 25 per cent, which is 2 per cent of all patients who had a positive IOC. The rate of stone extraction after positive IOC is low. Positive IOC may not warrant a routine postoperative ERCP. Our results suggest that clinical monitoring of patients with positive IOC is reasonable, as the majority of patients with a positive IOC ultimately have no stone extraction.

Is Laparoscopic Intraoperative Cholangiogram the Method of Choice? A Review of the Literature

2011 ◽  
Vol 58 (110-111) ◽  
Author(s):  
Hui Jiang ◽  
Hong Wu ◽  
Prasoon Pankaj ◽  
Jianguo Qiu ◽  
Yong Zeng
Keyword(s):  
Review Of The Literature ◽  
Intraoperative Cholangiogram

528 Is Routine Intraoperative Cholangiogram Necessary in the 21st Century? a National View

2012 ◽  
Vol 142 (5) ◽  
pp. S-1028
Author(s):  
Elizaveta Ragulin-Coyne ◽  
Elan R. Witkowski ◽  
Zeling Chau ◽  
Sing Chau Ng ◽  
Heena P. Santry ◽  
...  
Keyword(s):  
21St Century ◽  
Intraoperative Cholangiogram

Feasibility of Laparoscopic Intraoperative Cholangiogram in Patients with Intermediate Risk for Choledocholithiasis

2021 ◽  
Vol 8 (02) ◽  
pp. 108-114
Author(s):  
Adithya G.K. ◽  
Satya Prakash Jindal ◽  
Varun Madaan ◽  
Vachan Hukkeri ◽  
Rigved Gupta ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Liver Function ◽  
Liver Function Tests ◽  
Filling Defect ◽  
Primary Objective ◽  
Intermediate Risk ◽  
Intraoperative Cholangiogram ◽  
History Of ◽  
Technical Issues

BACKGROUND Intra-Operative Cholangiogram (IOC) is a procedure carried out during cholecystectomy with the primary objective of clearly delineating the biliary anatomy. Over decades, routine IOC became selective IOC and now it is being overtaken by less invasive investigations like MRCP and EUS. Role of IOC remains only to intraoperatively confirm or rule out bile duct injury in difficult cases. Laparoscopic IOC is a skilful procedure which requires training and extra added time during laparoscopic cholecystectomy. Once mastered it can be used in many situations for either anatomical reasons or to detect CBD pathology. METHODS All patients getting admitted for laparoscopic cholecystectomy with intermediate risk for choledocholithiasis were enrolled in the study from 2016 to 2019. Procedure was carried out with all necessary consents and precautions. All cases were performed by an experienced GI surgeon and followed up with proper protocol. RESULTS Fifty patients with known intermediate risk for choledocholithiasis underwent laparoscopic cholecystectomy with laparoscopic IOC. Procedure was successfully done in all patients except two, where cystic duct was very thin and cannulation was not possible. Forty-one (82%) patients had deranged liver function test and 9 patients (18%) had history of acute pancreatitis in the past as indications for the procedure. Two patients had dilated CBD (>6 mm) on ultrasound along with deranged liver function tests. An average of 12 minutes was taken to perform the procedure (range: 8 - 15 min). In cases where IOC took longer time was mainly due to technical issues (operability of C-arm). No IOC related complications occurred in any of the patients. Hospital stay was not prolonged in any of the patients due to IOC. None of the patients had any filling defect in CBD. All cases followed till date are asymptomatic. CONCLUSIONS It is a technically feasible procedure that can be performed with limited addition to OT time, minimal failure rate, and complications. All patients with limited criteria for intermediate risk of choledocholithiasis had a normal IOC with no evidence of biliary obstruction in follow up. KEYWORDS Laparoscopic Intraoperative Cholangiogram, Intermediate Risk, CBD Stones

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