PMID- 12886750
OWN - NLM
STAT- MEDLINE
DCOM- 20031020
LR  - 20161124
IS  - 0391-9005 (Print)
IS  - 0391-9005 (Linking)
VI  - 24
IP  - 4
DP  - 2003 Apr
TI  - [Intraoperative cholangiography during laparoscopic cholecystectomy: selective or 
      routine?].
PG  - 123-8
AB  - Since its presentation by Mirizzi in 1931, the role of intraoperative 
      cholangiography (ICHO) has been controversial and has become an argument even 
      more disputed with the introduction of laparoscopic cholecystectomy (VLC) in 
      1988. The Authors reviewed their experience to determine the most appropriate use 
      of ICHO during VLC on the basis of a retrospective analysis of cases of selective 
      ICHO. From December 1991 to January 2001, 597 patients, 552 elective procedure 
      and 45 emergency procedure, were reviewed. Of 552 patients 62 presented with at 
      least one diagnostic criterion for symptomatic gallstone disease and were treated 
      by means of ERCP completed with endoscopic sphincterectomy (ES) when a stone of 
      the common bile duct was found, while the remaining 490 patients underwent VLC; a 
      total of 10 ICHO were performed, two of which in the ERCP group and 8 in the VLC 
      group. The 45 patients treated in emergency underwent VLC; in 43 cases ICHO was 
      performed. Of all patients, there were 2 cases of common bile duct injuries 
      (0.33%) and in both cases ICHO was not performed. A cholangiogram added 27 min to 
      the average duration of surgery. On the basis of both the literature and Authors' 
      experience, it can be stated that the routine use of ICHO is not useful to reduce 
      bile duct injuries, while it significantly increases the cost of the surgical 
      procedure due to the increase of average operative time. The use of ICHO seems to 
      be effective to demonstrate clinically unsuspected choledocholitiasis, although, 
      at present, the real clinical advantage deriving from the detection of these 
      stones is not clear. The Authors conclude that further prospective, randomized 
      studies are necessary to assess the precise role of ICHO with regard to VLC.
FAU - Piacentini, F
AU  - Piacentini F
AD  - Cattedra e Scuola di Specializzazione in Chirurgia Generale, Universita degli 
      Studi di L'Aquilia.
FAU - Perri, S
AU  - Perri S
FAU - Pietrangeli, F
AU  - Pietrangeli F
FAU - Nardi, M Jr
AU  - Nardi M Jr
FAU - Dalla Torre, A
AU  - Dalla Torre A
FAU - Nicita, A
AU  - Nicita A
FAU - Lotti, R
AU  - Lotti R
FAU - Castaldo, P
AU  - Castaldo P
FAU - Gabbrielli, F
AU  - Gabbrielli F
FAU - Castiglia, D
AU  - Castiglia D
FAU - Citone, G
AU  - Citone G
LA  - ita
PT  - Comparative Study
PT  - Journal Article
TT  - Colangiografia intraoperatoria in corso di colecistectomia laparoscopica: 
      selettiva o di routine?
PL  - Italy
TA  - G Chir
JT  - Il Giornale di chirurgia
JID - 9011768
SB  - IM
MH  - *Cholangiography
MH  - Cholangiopancreatography, Endoscopic Retrograde
MH  - *Cholecystectomy, Laparoscopic
MH  - Cholelithiasis/*surgery
MH  - Common Bile Duct/injuries
MH  - Emergencies
MH  - Follow-Up Studies
MH  - Gallstones/*diagnostic imaging
MH  - Humans
MH  - Iatrogenic Disease
MH  - Retrospective Studies
MH  - Time Factors
EDAT- 2003/07/31 05:00
MHDA- 2003/10/21 05:00
CRDT- 2003/07/31 05:00
PHST- 2003/07/31 05:00 [pubmed]
PHST- 2003/10/21 05:00 [medline]
PHST- 2003/07/31 05:00 [entrez]
PST - ppublish
SO  - G Chir. 2003 Apr;24(4):123-8.