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Related Experiment Video

Updated: Jul 11, 2026

Laparoscopic Cholecystectomy with Indocyanine Green Fluorescence: Choledochoscopic Stone Extraction and Primary Duct Suture
04:02

Laparoscopic Cholecystectomy with Indocyanine Green Fluorescence: Choledochoscopic Stone Extraction and Primary Duct Suture

Published on: November 25, 2025

Laparoscopic cholecystectomy without intraoperative cholangiography.

Emmanouil Zacharakis1, Stamatis Angelopoulos, Dimitrios Kanellos

  • 14th Academic Surgical Unit, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece. manoszacharakis@hotmail.com

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|October 3, 2007
PubMed
Summary

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Laparoscopic cholecystectomies (LCs) without routine intraoperative cholangiograms (IOCs) resulted in a low bile duct injury (BDI) rate of 0.37%. This study suggests LCs can be safely performed without IOCs by experienced surgeons.

Area of Science:

  • Gastroenterology
  • Surgical Innovation
  • Patient Safety

Background:

  • Laparoscopic cholecystectomy (LC) is a common surgical procedure.
  • Intraoperative cholangiography (IOC) is often used to prevent bile duct injuries (BDIs).
  • This study evaluates outcomes of LC without IOCs.

Purpose of the Study:

  • To assess the outcomes of laparoscopic cholecystectomies (LCs).
  • To determine the impact of a no-IOC policy on bile duct injury (BDI) incidence.
  • To evaluate the safety and efficacy of LC without IOCs.

Main Methods:

  • Retrospective review of 1851 LC procedures performed between 1992 and 2005.
  • Patients with pre-existing biliary issues underwent ERCP prior to LC.
  • Intraoperative cholangiograms (IOCs) were not performed on any patient.

Related Experiment Videos

Last Updated: Jul 11, 2026

Laparoscopic Cholecystectomy with Indocyanine Green Fluorescence: Choledochoscopic Stone Extraction and Primary Duct Suture
04:02

Laparoscopic Cholecystectomy with Indocyanine Green Fluorescence: Choledochoscopic Stone Extraction and Primary Duct Suture

Published on: November 25, 2025

Main Results:

  • The overall bile duct injury (BDI) rate was 0.37% (7 of 1851 patients).
  • Conversion rates differed significantly between acute (23.9%) and non-inflamed (1.6%) cholecystitis.
  • Morbidity was 1.1%, with 6 minor and 1 major BDI.

Conclusions:

  • A low bile duct injury (BDI) rate supports performing laparoscopic cholecystectomy (LC) without intraoperative cholangiograms (IOCs).
  • Meticulous surgical technique, anatomical knowledge, and a low threshold for conversion are crucial for safe LC.
  • Routine or selective cholangiography is not inherently wrong but not essential for achieving satisfactory results.