ENDOSCOPIC RETROGRADE CHOLANGIOGRAPHY AS A PRELUDE TO LAPAROSCOPIC CHOLECYSTECTOMY

Seventy patients undergoing laparoscopic cholecystectomy were evaluated with endoscopic retrograde cholangiography (ERC) preoperatively, All the ERCs were performed by the laparoscopic surgeon, 1 to 30 days prior to surgery. In all cases including those converted to open cholecystectomy (5 out of 70, 7.1%), ERC helped in clear delineation of the biliary tree, cystic duct and gallbladder, making dissection of the Calot's triangle safe. Four cases of common bile duct (CBD) stones detected at ERC were managed by papillotomy and basketing. In nine cases (12.8%), anomalies of the biliary tree were detected. Average time taken for ERC was 12 minutes (7-28 minutes); while intraopertaive cholangiogram (one case) took 25 minutes. ERC gives a clear outline of the biliary anatomy and greatly facilitates laparoscopic cholecystectomy, It helps avoid open cholecystectomy because of CBD stones. It also reduces the laparoscopic operating time by the duration normally taken to do intraoperative cholangiography.