Selective versus routine intra-operative cholangiography during cholecystectomy

ABSTRACT

This study aimed to examine the selective criteria for intraoperative cholangiography by measuring their sensitivity, specificity, positive predictive value and negative predictive value. The ability of these indicators to predict CBD stones at cholecystectomy was measured, so the role of selective intraoperative cholangiography can be evaluated. The study included 70 patients with gall bladder stones with no prove of concomitant CBD stones by clinical and ultrasonographic examination. Patients were subjected to cholecystectomy with routine intraoperative cholangiography. Out of them, eight had positive cholangiograms and common bile duct [CBD] stones. So, many unnecessary cholangiograms were performed with loss of money and time with associated morbidity. The clinical, laboratory, radiological and operative data of all cases were reviewed compared with cholangiograms. Certain parameters or criteria were common in patients with positive cholangiograms. The study also tried to determine certain criteria to select patients at high risk to perform selective intraoperative cholangiography