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Percutaneous transcholecystic cholangiography during laparoscopic cholecystectomy
N G Richardson1, N A Mcintosh, R G Sarre
1Department of Surgery, Flinders Medical Centre, Adelaide, South Australia, Australia.
Background:
Controversy still exists regarding the role of routine cholangiography in laparoscopic cholecystectomy. Although the need to identify common bile duct stones is perhaps less critical than it was in the past, confirmation of anatomy by peroperative cholangiography is important for both clinical and medico-legal purposes. Conventionally, contrast has been introduced into the biliary tree via the cystic duct after dissection of Calot's triangle.
Methods:
A simple technique of cholangiography by direct gall-bladder puncture is described, which can be done quickly and easily at the beginning of the operation.
Results:
The retrospective analysis of 250 consecutive cases shows the technique to be safe, accurate and to provide useful cholangiograms in 85% of cases.
Conclusions:
Percutaneous transcholecystic cholangiography can be performed readily without special equipment. It provides valuable anatomical information in 85% of cases before commencing dissection of the cystic duct.