Unsuspected choledocholithiasis found by routine intra‐operative cholangiography during laparoscopic cholecystectomy

2020 ◽  
Vol 90 (11) ◽  
pp. 2279-2284
Author(s):  
Robert S. O'Neill ◽  
Sarah Z. Wennmacker ◽  
Nazim Bhimani ◽  
Aafke H. Dijk ◽  
Philip Reuver ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Operative Cholangiography

Operative cholangiography performed during laparoscopic cholecystectomy

1993 ◽  
Vol 14 (5) ◽  
pp. 325-330
Author(s):  
Suppiah Balachandran ◽  
William H. Nealon ◽  
Philip Goodman
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Operative Cholangiography

Evaluation of operative cholangiography in 2043 patients undergoing laparoscopic cholecystectomy

2001 ◽  
Vol 15 (1) ◽  
pp. 14-20 ◽  
Author(s):  
L. L. Snow ◽  
L. S. Weinstein ◽  
J. K. Hannon ◽  
D. R. Lane
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Operative Cholangiography

Usefulness of the Preoperative NBD-T for Operative Cholangiography in Laparoscopic Cholecystectomy

1992 ◽  
Vol 2 (2) ◽  
pp. 172
Author(s):  
Yasuyuki Yazaki ◽  
Masayosi Namiki ◽  
Hiromi Sakata ◽  
Hiromi Kotani ◽  
Kazunori Kamiya ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Operative Cholangiography

scholarly journals P-BN59 Danger is there, do we want to know about it? Routine intra operative cholangiography highlights dangerous biliary anatomy for safer cholecystectomy

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Noor Ul ain ◽  
Saira Bibi ◽  
Ian Tait ◽  
Samer Zino
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Bile Duct Injury ◽  
Cystic Duct ◽  
Filling Defect ◽  
Single Session ◽  
Biliary Anatomy ◽  
Operative Cholangiography ◽  
Transcystic Approach ◽  
Contrast Flow

Abstract Background Normal biliary anatomy is uncommon. Different classification for biliary anatomy has been described, with Huang Types A4 & A5 of great interest for laparoscopic cholecystectomy (LC) due to the proximity of aberrant bile duct to Cystic duct (CD). These types of dangerous anatomy might contribute to bile duct injury. This study aims to analyse the prevalence of dangerous biliary anatomy. Methods Prospectively collected data for all patients who underwent laparoscopic cholecystectomy was analysed. All LC were performed by single surgeon or under  his direct supervision, between 01/07/2020 and 20/08/2021. Index admission and single session management of cholelithiasis disease with routine Laparoscopic cholecystectomy + intra operative cholangiography (IOC) +/- LCBD exploration were standard practice. Results Laparoscopic cholecystectomy was performed in 137 patients. Mean age was 56y (17-84).  62% were females.   66% of Laparoscopic cholecystectomies were emergency. IOC was performed in 92% of cases. Abnormal biliary anatomy was found in 54% : Huang A1 - 48%, A2 - 29%, A3 - 12%, A4 - 9.7% and A5 - 0.7%. Dangerous anatomy (A4 and A5) was found in 10.5%, 78 % were females.  Female with dangerous anatomy were younger than males 49 y, 60y respectively. Nassar difficulty grading for dangerous anatomy was as follows: G2 28%, G3 42% and G3 28% Abnormal cholangiogram was found in 48%, due to filling defect in 58%, no contrast flow into duodenum in 4%, Cystic duct stone in 4%, and short CD in 8%. CBD stones were treated using transcystic approach in 92% of cases. No intra-operative or post operative complications were recorded for patients with dangerous anatomy.  Conclusions This study demonstrates that dangerous biliary anatomy, that could lead to bile duct injury is relatively common, occurring in 10.7% of LCs. Routine intra-operative cholangiography highlights these high-risk variations in biliary anatomy and may prevent inadvertent bile duct injury in such cases.

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