Annals of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회지)

The Korean Association of Hepato-Biliary-Pancreatic Surgery (한국간담췌외과학회)
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Systematic intraoperative cholangiography during elective laparoscopic cholecystectomy: Is it a justifiable practice?

  • Francesco Esposito (Visceral and Digestive Surgery Unit, Grand Hopital de l'Est Francilien) ;
  • Iolanda Scoleri (Visceral and Digestive Surgery Unit, Grand Hopital de l'Est Francilien) ;
  • Rafika Cattan (Visceral and Digestive Surgery Unit, Grand Hopital de l'Est Francilien) ;
  • Marie Cecile Cook (Visceral and Digestive Surgery Unit, Grand Hopital de l'Est Francilien) ;
  • Dorin Sacrieru (Visceral and Digestive Surgery Unit, Grand Hopital de l'Est Francilien) ;
  • Nouredine Meziani (Visceral and Digestive Surgery Unit, Grand Hopital de l'Est Francilien) ;
  • Marco Del Prete (Visceral and Digestive Surgery Unit, Grand Hopital de l'Est Francilien) ;
  • Morad Kabbej (Visceral and Digestive Surgery Unit, Grand Hopital de l'Est Francilien)
  • Received : 2022.10.06
  • Accepted : 2022.11.24
  • Published : 2023.05.31
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Abstract

Backgrounds/Aims: Routine execution of intraoperative cholangiography (IOC) in laparoscopic cholecystectomy (LC) is considered a good practice to help early identification of biliary duct injuries (BDIs) or common bile duct (CBD) stones. This study aimed to determine the impact of IOC during LC. Methods: This is a retrospective, monocentric study, including patients with a LC performed from January 2020 to December 2021. Results: Of 303 patients, 215 (71.0%) were in the IOC group and 88 (29.0%) in the no-IOC group. IOC was incomplete or unclear in 10.7% of patients, with a failure rate of 14.7%. Operating time was 15 minutes longer in the IOC group (p = 0.01), and postoperative complications were higher (5.1% vs. 0.0%, p = 0.03). There were three BDIs (0.99%), all included in the IOC group; only one was diagnosed intraoperatively, and the other two were identified during the postoperative course. Regarding identifying CBD stones, IOC showed a sensitivity of 77%, a specificity of 98%, an accuracy of 97.2%, a positive predictive value of 63% and a negative predictive value of 99%. Conclusions: Systematic IOC has shown no specific benefits and prolonged operative duration. IOC should be performed on selected patients or in situations of uncertainty on the anatomy.

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References

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