Suggested new rules for exploration of the common bile duct at cholecystectomy

Traditional indications for exploration of the common bile duct have been made anachronistic by developments in operative cholangiography. A new technique of contact cholangiography, described in this paper, improves the precision of operative cholangiography and allows the traditional indications for exploration to be modified. A new set of guidelines for exploration of the common duct, based on high-quality operative cholangiography, is outlined, and the place of the supraduodenal and transduodenal routes for exploration is discussed. The results of the application of these policies in a series of 120 cholecystectomies are presented.