Selective contraindications based on multivariate analysis for operative cholangiography in biliary lithiasis

This study was done to select patients with a low risk of common bile duct (CBD) stones in whom operative cholangiography could be avoided. Operative cholangiography was performed upon 511 patients. Two different groups of patients were identified--patients with CBD stones visualized by CBD exploration (n = 90) and patients with no CBD stones at the time of operative cholangiography (n = 421). Multivariate analysis (stepwise logistic regression) showed that five variables were correlated with the presence of CBD stones--size of CBD equal to or greater than 12 millimeters, gallstones equal to or less than 10 millimeters, advanced age, chronic or acute cholecystitis and past history of biliary colic. Using a scoring system, a group of patients with a low risk (less than 2 percent) of CBD stones could be easily determined. In this group of patients, operative cholangiography may be avoided.