Efficacy of Cholangiography Under Helical Computed Tomography for Laparoscopic Cholecystectomy

Takeuchi, Masafumi; Hishiyama, Houhei; Kondo, Satoshi; Katoh, Hiroyuki

doi:10.1007/s005950200059

Cited by 12 publications

(4 citation statements)

References 16 publications

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“…It is generally accepted that iotroxate contrast medium can be used at greater concentrations in the biliary tract and is less allergenic 10 . A report on the use of 100 mL of iotroxate contrast medium in 196 patients showed only two minor and no severe or fatal reactions 11 and in this study, no patients had an adverse reaction. Therefore, DIC‐CT may be safer than previously suggested.…”

Section: Discussionsupporting

confidence: 54%

Efficacy of Multi‐slice Computed Tomography Cholangiography Before Laparoscopic Cholecystectomy

Hirano

Tatsuzawa

Shimizu

et al. 2006

ANZ Journal of Surgery

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Section: Discussionsupporting

confidence: 54%

Efficacy of Multi‐slice Computed Tomography Cholangiography Before Laparoscopic Cholecystectomy

Hirano

Tatsuzawa

Shimizu

et al. 2006

ANZ Journal of Surgery

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Section: Clinical Relevance Of Dic-ct For Identifying Subvesical Ductsmentioning

confidence: 99%

“…Presurgical CT-cholangiography could play an important role in detecting subvesical ducts, and recently many hospitals have adopted this method [19][20][21][22]. It reduces the duration of laparoscopic cholecystectomy [22]. Presurgical magnetic resonance cholangio pancreatography (MRCP) has the same effect as CTcholangiography [23].…”

Section: Clinical Relevance Of Dic-ct For Identifying Subvesical Ductsmentioning

confidence: 99%

Heterogeneity of Subvesical Ducts or the Ducts of Luschka: A Study Using Drip‐infusion Cholangiography‐Computed Tomography in Patients and Cadaver Specimens

et al. 2005

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The objective of this study was to examine the heterogeneity of the subvesical duct or the ducts of Luschka as well as the reliability of drip-infusion cholangiography with computed tomography (DIC-CT) for their identification. DIC-CT was used in 277 consecutive patients (135 men, 142 women) and for the dissection and histologic study of 10 cadaver livers. We found 32 subvesical ducts in 28 (10.1%) of 277 patients. Irrespective of whether the terminals were extra- or intraparenchymal, the subvesical ducts often (17/32 ducts, 15/28 patients) drained into a subsegmental duct of S5 or S4. Notably, some displayed an "intermediate" course along the gallbladder fossa with an intraparenchymal origin and terminated at S5. Such ducts tended to be seen in the elderly. Another 15 ducts drained into a thick, centrally located duct, such as the right sectorial or hepatic duct. The anatomic study demonstrated that the subvesical duct likely included the cystic vein-concomitant duct. A major type of subvesical duct, characterized by an intermediate course along its bed, appeared to result from degenerative exposure of a peripheral duct with aging. The subvesical duct draining into the thick duct included both a "daughter branch," such as seen in the lung, and the so-called anomaly. Such ducts can be demonstrated with DIC-CT, but the incidence might be limited. However, the cystic vein/concomitant duct was difficult to identify radiologically. Consequently, although presurgical radiology is useful for avoiding bile leakage after laparoscopic cholecystectomy, surgeons should be aware of its limitations.

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“…With improvements in image quality and radiation exposure, CT cholangiography (CTC) is able to provide reliable and detailed assessment of biliary anatomy prior to commencing the operation. Its purported benefits include shorter operative time, reduced rates of open conversion, and reduced incidence of post-operative complications [ 8 ]. However, data on its effectiveness and performance relative to routine IOC is lacking.…”

Section: Introductionmentioning

confidence: 99%

Comparison of pre-operative computed tomography cholangiography and intraoperative cholangiography in laparoscopic cholecystectomy: a retrospective analysis

Chung

2023

BMC Surg

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Background The role of intra-operative cholangiography (IOC) in laparoscopic cholecystectomy (LC) is controversial. CT cholangiography (CTC) provides a reliable assessment of biliary anatomy, potentially reducing operating times, open conversion, and complication rates. This study aims to assess the safety and effectiveness of routine pre-operative CTC. Methods A single centre retrospective analysis was undertaken of all elective laparoscopic cholecystectomies between 2017 and 2021. Information was obtained from a general surgical database alongside hospital electronic medical records. T-tests and Chi2 tests were used to assess statistical significance. Results Of 1079 patients, 129 (12.0%) underwent routine pre-operative CTC, 786 (72.8%) routine IOC, and 161 patients (14.9%) neither modality. Comparing CTC and IOC, the CTC group had higher rates of open conversion (3.1% vs. 0.6%, p 0.009), subtotal cholecystectomies (3.1% vs. 0.8%, p 0.018), and length of stay (1.47 vs. 1.18 nights, p 0.015). Comparing the prior groups together against those utilising neither modality, the latter had reduced operative time (66.29 vs. 72.47, p 0.011), but increased rate of bile leak (1.9% vs. 0.4%, p 0.037) and bile duct injury (1.2% vs. 0.2%, p 0.049). Co-dependence between operative complications was noted in linear regression. Conclusion Biliary imaging with either CTC or IOC is beneficial in reducing bile leak and bile duct injury, and its routine use LC is recommended. However, routine CTC is inferior to routine IOC in preventing conversions to open surgery and subtotal cholecystectomy. Further research may be undertaken to evaluate criteria for a selective CTC protocol.

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Efficacy of Cholangiography Under Helical Computed Tomography for Laparoscopic Cholecystectomy

Abstract: These findings provide evidence to support the advantages of helical CT cholangiography in relation to operative time, conversion, and procedure-related preoperative complications.

Cited by 12 publications

References 16 publications

Efficacy of Multi‐slice Computed Tomography Cholangiography Before Laparoscopic Cholecystectomy

Efficacy of Multi‐slice Computed Tomography Cholangiography Before Laparoscopic Cholecystectomy

Heterogeneity of Subvesical Ducts or the Ducts of Luschka: A Study Using Drip‐infusion Cholangiography‐Computed Tomography in Patients and Cadaver Specimens

Comparison of pre-operative computed tomography cholangiography and intraoperative cholangiography in laparoscopic cholecystectomy: a retrospective analysis

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