Cholecystectomy and a simple technique of operative cholangiography

A simple, easily reproducible technique of operative cholangiography is described. The technique has three advantages: (a) there is no need to divide or ligate the cystic duct; (b) it demonstrates the cystic duct anatomy clearly and is particularly useful in demonstrating stones in that duct thus eliminating the hazard of the retained stone in the cystic duct stump; (c) it is possible to eliminate the problem of false positives due to air bubbles. A consecutive series of 442 cholecystectomy patients is reviewed. The overall operative mortality was 1.6 per cent; no death could be attributed to operative cholangiography. Thirty-five of 324 patients (10.8 per cent) with gallstones and no history of jaundice were shown to have unexpected abnormalities in the common bile duct.