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Related Experiment Video

Updated: Jul 6, 2026

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

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

Published on: November 25, 2025

Optimising laparoscopic cholangiography time using a simple cannulation technique.

Ahmad H M Nassar¹, Gamal El Shallaly, Ahmed H Hamouda

¹Department of Surgery, Laparoscopic and Upper GI Unit, Monklands Hospital, Airdrie, Lanarkshire, Scotland, UK. A.Nassar@clinmed.gla.ac.uk

Surgical Endoscopy

|April 9, 2008

Summary

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A new cystic duct cannulation technique optimizes intraoperative cholangiography (IOC) time, making this vital diagnostic tool feasible for routine use in laparoscopic cholecystectomy. This method reduces procedure time, addressing concerns about technical difficulty and duration.

Area of Science:

Surgical Innovation
Gastrointestinal Surgery
Diagnostic Imaging

Background:

Concerns exist regarding the technical difficulty and time required for routine intraoperative cholangiography (IOC).
These challenges may limit the adoption of IOC in laparoscopic procedures.

Purpose of the Study:

To evaluate the impact of a specific cystic duct cannulation (CDC) technique on IOC duration.
To assess the learnability and efficiency of the CDC technique in laparoscopic cholecystectomy.

Main Methods:

A prospective audit of 243 laparoscopic cholecystectomies (LCs) over 18 months was conducted.
Intraoperative cholangiography (IOC) time, including cystic duct cannulation (CDC) and fluoroscopy time, was recorded.
Data were analyzed based on cannulation difficulty, operator experience, and concurrent laparoscopic common bile duct exploration (LCBDE).

Related Experiment Videos

Last Updated: Jul 6, 2026

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

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

Published on: November 25, 2025

Main Results:

The mean total IOC time was 6 minutes (CDC: 2 min, Fluoroscopy: 4 min).
In 86% of cases with easy cannulation, mean IOC time was 4.3 minutes.
Difficult cannulation (14% of cases) increased mean IOC time to 8.5 minutes; LCBDE cases averaged 13 minutes.

Conclusions:

A simple, learnable CDC technique can optimize IOC time to under 5 minutes in most laparoscopic cholecystectomies.
This technique supports the routine or selective use of IOC, even in cases with suspected bile duct stones.
Surgeons should not avoid IOC due to perceived technical difficulties or time constraints.