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Related Experiment Video

Updated: Jan 3, 2026

Laparoscopic Cholecystectomy with Indocyanine Green Fluorescence: Choledochoscopic Stone Extraction and Primary Duct Suture
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[Intraoperative cholangiography: its value in simple cholelithiasis].

J Ibáñez Aguirre, J Santoyo Santoyo, P Rico Selas

    Revista Espanola De Las Enfermedades Del Aparato Digestivo
    |March 1, 1989
    PubMed
    Summary

    Routine intraoperative cholangiography (CIO) in patients without suspected bile duct stones offers minimal benefit. This study found CIO increased costs and operative time, with few confirmed diagnoses, suggesting it is not cost-effective.

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    Area of Science:

    • Gastroenterology
    • Surgical Oncology
    • Hepatobiliary Surgery

    Background:

    • Choledocholithiasis diagnosis often relies on preoperative imaging.
    • Intraoperative cholangiography (CIO) is sometimes used to detect bile duct stones.
    • The utility of routine CIO in patients without preoperative suspicion is debated.

    Purpose of the Study:

    • To evaluate the benefits and drawbacks of systematic intraoperative cholangiography (CIO).
    • To assess the diagnostic yield of CIO in patients without preoperative suspicion of choledocholithiasis.

    Main Methods:

    • A prospective study involving 144 patients undergoing surgery.
    • Systematic intraoperative cholangiography (CIO) was performed on all patients.
    • Surgeons assessed cholangiography results for abnormalities and confirmed diagnoses.

    Main Results:

    • Abnormalities were found in 7.6% of CIOs, with choledocholithiasis confirmed in only 3 cases (2.1% of total patients).
    • Unsuspected main bile duct pathology was identified in only 2% of patients.
    • False positive results occurred in 5% of cases, leading to unnecessary procedures.

    Conclusions:

    • Routine CIO in patients without preoperative suspicion of choledocholithiasis is not cost-effective.
    • CIO increases surgical costs, operative time, and radiation exposure.
    • It can lead to unnecessary interventions and prolonged hospital stays due to false positives.