Operative Cholangiography

Jolly, Philip C.; Baker, Joel W.; Schmidt, Helen M.; Walker, John H.; Holm, Jess C.

doi:10.1097/00000658-196809000-00019

Cited by 76 publications

(8 citation statements)

References 8 publications

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“…The pancreatic head and associated blood vessels can be visualized by ultrasound (Figs. 5,7,8). Sonography also may localize the common bile duct and other key structures when they are obscured by tumor or an inflammatory mass [22,24].…”

Section: Discussionmentioning

confidence: 99%

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Comparison of operative ultrasonography and radiography in screening of the common bile duct for calculi

et al. 1987

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We report a 4-year experience of operative ultrasonography in 449 patients who underwent cholecystectomy for biliary lithiasis. Intraoperative uttrasonography and intraoperative cholangiography were performed in all of these patients and compared with the operative findings. The diagnostic accuracy of sonography was 97.5% and that of chalangiography was 94.4% in the patient group as a whole. The predictive value of a positive sonogram in this group was 96.4%, while that of a positive cholangiogram was lower at 86.9%. In 148 patients who underwent surgical exploration of the common duct, sonography appeared to have more accurately predicted presence or absence of stones (92.5 %) than did cholangiography (79.8%). Use of these intraoperative screening tests together led to a positive common duct exploration in 76.6% of the 148 patients, which is higher than our previous experience in which common duct exploration was performed on the basis of clinical criteria. In 7% of the 301 cholecystectomized patients, nnpredicted stones were detected at operative sonography and cholangiography. If the common duct exploration were to be performed based solely on the outcome of the sonogram, the rate of positive exploration could be 97%. Overall morbidity in this series was 9%, and retained stones following duct exploration were encountered in 1 patient. The overall mortality rate of the entire patient group was 0.9%. Operative ultrasonography of the biiiary tract as a screening procedure is, in experienced hands, a reliable method and substitute for operative cholangiography.

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Section: Discussionmentioning

confidence: 99%

“…Many previous reports [1,[6][7][8][9][10][11][12] have supported routine operative cholangiography for such purposes. Some authors have suggested, however, that cholangiography may not be cost-effective as a screening procedure except when CBD disease is clinically suspected [12][13][14][15][16].…”

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confidence: 99%

Comparison of operative ultrasonography and radiography in screening of the common bile duct for calculi

et al. 1987

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“…Operative cholangiography is an established means of assessing the common duct for calculi during cholecystectomy [1][2][3][4][5][6]. This radiographic procedure using contrast material has substantially improved the selection of common ducts requiring choledochotomy and exploration.…”

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confidence: 99%

Comparison of cholangiography and ultrasonography in the operative screening of the common bile duct

et al. 1982

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Operative cholangiography and operative real‐time, B‐mode ultrasound scanning were compared as the initial screening tests for calculi in the common bile duct. On the basis of experience at 150 operations, the 2 tests were comparable in terms of sensitivity, specificity, efficiency, and predictability of a negative test. Ultrasound was associated with a higher predictability of a positive test than was cholangiography. However, this difference was not significant. Operative Ultrasonography appears to match the accuracy of operative cholangiography as a screening test for stones in the common duct. The disadvantage of ultrasound is that most surgeons are currently not familiar with its performance and interpretation. The advantages are that ultrasound is less time‐consuming and requires less tissue manipulation and no contrast material injection or exposure to radiation.

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“…There is considerable argument regarding the merits and demerits of operative cholangiography. Jolly et al (1968) noted that this technique added only a few minutes to their operating time. Kakos et al (1972) stated that by its use there was a decrease in the number of patients undergoing choledochotomy from 41% to 25%.…”

Section: Introductionmentioning

confidence: 99%

Value of Operative Cholangiography

Chatterjee¹,

Jones²

1978

Int J Clinical Practice

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Operative cholangiography can reduce the incidence of duct exploration. It also prevents reexploration by demonstrating overlooked stones. No mortality and real morbidity could be attributed to the procedure in this present series. Out of 136 cases, 19 showed abnormal cholangiogram where common bile duct exploration was done. Five patients would have undergone common duct exploration anyway on clinical grounds; eleven patients were found to have unexpected common duct stones, and three patients were not found to have stones' at common bile duct exploration.On the basis of this study, we conclude that operative cholangiogram technique is a rapid, safe, and useful procedure which should be carried out routinely.

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Operative Cholangiography

Cited by 76 publications

References 8 publications

Comparison of operative ultrasonography and radiography in screening of the common bile duct for calculi

Comparison of operative ultrasonography and radiography in screening of the common bile duct for calculi

Comparison of cholangiography and ultrasonography in the operative screening of the common bile duct

Value of Operative Cholangiography

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