A five years review intra-operative cholangiogram
1Department of Surgery, Patan Hospital, Patan Academy of Health Sciences, Lalitpur, Kathmandu, Nepal. drjaywufei@hotmail.com
Journal of Nepal Health Research Council
|August 30, 2012
Summary
Intra-operative cholangiogram during cholecystectomy has low detection rates for bile duct stones and high false positive results. Redefining indications for this procedure is crucial to reduce unnecessary interventions and associated morbidity.
Area of Science:
- Gastroenterology
- Surgical Procedures
- Diagnostic Imaging
Background:
- Intra-operative cholangiogram (IOC) is used to detect common bile duct stones during cholecystectomy.
- Routine IOC can lead to unnecessary common bile duct exploration due to frequent false positives, increasing costs and morbidity.
Purpose of the Study:
- To evaluate the effectiveness of current indications for IOC in identifying common bile duct stones.
- To highlight the need for improved indicators for IOC to minimize unnecessary procedures.
Main Methods:
- Retrospective analysis of 2400 cholecystectomy patients from October 2005 to September 2009.
- Analysis of IOC indications, outcomes, and correlation with common bile duct exploration findings.
Main Results:
- 68 IOCs (2.8%) were performed in 2400 cholecystectomies.
- Abnormal findings were noted in 8 patients (11.8%), with only 2 (3%) confirmed common bile duct stones.
- No mortality was reported in the series.
Conclusions:
- Current indications for IOC are insufficient for detecting bile duct stones, leading to high false-positive rates.
- Unnecessary common bile duct exploration increases costs and patient morbidity.
- There is a clear need to redefine the indications for intra-operative cholangiogram.
