Selective intraoperative cholangiography (IOC) during laparoscopic cholecystectomy is a safe practice when the ductal anatomy is clearly defined and there is no laboratory or clinical evidence of common bile duct abnormalities.
Preoperative Indications
- Recent history of acute biliary pancreatitis
- Recent history of jaundice
- Recent history of cholangitis
- Abnormal preoperative ultrasound demonstrating a dilated common bile duct or a defect (stone) in the common bile duct
- Evidence of common bile duct obstruction on hepatobiliary iminodiacetic acid scan (HIDA Scan)
- Increased serum bilirrubin
- Increased serum alkaline phophatase
- Increased serum amylase
Intraoperative Indications
- Dilated extrahepatic bile ducts
- Unusual anatomy or inability to discern anatomy
- Concern or suspicion of bile duct injury
References:
- Dorazio RA. Selective operative cholangiography in laparoscopic cholecystectomy. Am Surg. 1995 Oct;61(10):911-3. [Medline]
- Robinson BL, Donohue JH, Gunes S, Thompson GB, Grant CS, Sarr MG, Farnell MB, van Heerden JA. Selective operative cholangiography. Appropriate management for laparoscopic cholecystectomy. Arch Surg. 1995 Jun;130(6):625-30. [Medline]
Created: Aug 17, 2009