Intraoperative Cholangiography

Abstract

A retrospective review was performed of patients who had biliary tract stone formation as the primary diagnosis for hospitalization and indication for surgery. A total of 589 consecutive charts were reviewed of patients admitted between 1975-1979. Intraoperative cholangiography [ICG] was performed in 166 patients of whom 22 had common duct exploration. Choledochotomy in this series was performed in 63 cases without utilizing pre-exploratory cholangiography. A normal ICG was 100% accurate; however, an abnormal chlolangiogram was associated with a 16% false positive rate of exploration of the common duct. The incidence of unsuspected common duct stones detected only by ICG was 2.3%. Age-sex analysis confirms a 10-yr mean age difference between men and women within the population of this study (P < 0.001). This age-sex difference is maintained in patients without common duct pathology as well as in patients with sterile bile. However, the mean age difference between male and female patients with either demonstrable common duct obstruction by stones or infected bile as determined by routine intraoperative culture is not statistically significant. A review of the role of ICG and the experience at Northeastern Hospital Philadelphia, Pa, USA, is discussed.