Transcystic duct operative cholangiography. Personal experiences with 500 consecutive cases

Of 500 consecutive cholecystectomy patients, sixty-nine had clinical indications for common bile duct exploration and twenty-nine of these yielded stones for an overall accuracy rate of 42%. Of the 431 remaining patients, thirty-six demonstrated abnormal cholangiograms and in these, twenty-six yielded stones within the common duct, representing and incidence of 6% of unsuspected stones. Of the total series of 500 patients, sixty-one showed cholangiographic indications for common duct exploration and fifty were positive for stones for an overall accuracy of 82%. The overall incidence of common duct stone recovery was 11%. It is concluded that transcystic duct operative cholangiography should be performed routinely during cholecystectomy when feasible.