Intraoperative Cholangiogram Facilitates Single-Session Laparoscopic Cholecystectomy and Intraoperative Endoscopic Retrograde Cholangiopancreatography: Case Reports and Review of the Literature

Abstract

Choledocholithiasis is reported in up to 20% of patients undergoing cholecystectomy. It is recommended to remove common bile duct gallstones due to the risk of complications. A common approach to the management of choledocholithiasis is to combine laparoscopic cholecystectomy (LC) with endoscopic retrograde cholangiopancreatography (ERCP), which is typically completed during two separate sessions. The use of intraoperative cholangiogram (IOC) to facilitate combined LC and intraoperative endoscopic retrograde cholangiopancreatography (iERCP) may reduce overall operative time and hospital length of stay. We report two patients who underwent LC and iERCP under the same anesthetic administration for the treatment of choledocholithiasis. A large data set on the role of IOC in completing both LC and iERCP under a single anesthetic administration was analyzed. These two patients illustrate the utility of IOC in facilitating single-session LC/iERCP for the treatment of choledocholithiasis and our retrospective analysis highlights the effectiveness of IOC.