Nonroutine Operative Cholangiography

Abstract

Over a seven-year period, operative cholangiography at the time of cholecystectomy was selectively omitted in patients with (1) a solitary gallbladder stone, (2) a cystic duct of minute caliber, (3) acute cholecystitis operated on when regular roentgenographic personnel were not available, and (4) cholecystectomy as an incidental procedure. Thirty-four patients not having cholangiography and 72 patients having cholangiography were observed for an average period of 34 months. The study indicates that serious pathological findings (stones and carcinoma) were undetected at cholecystectomy in 11.8% of the patients not having cholangiography and in 1.4% of the patients having cholangiography. The results suggest that the surgeon who decides to omit cholangiography during cholecystectomy should closely examine the criteria on which he bases his decision.