Unifying Concepts

Indications for Selective Operative Cholangiography

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




  1. Dorazio RA. Selective operative cholangiography in laparoscopic cholecystectomy. Am Surg. 1995 Oct;61(10):911-3. [Medline]
  2. 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

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