Has intraoperative cholangiography during laparoscopic cholecystectomy become obsolete in the era of preoperative endoscopic retrograde and magnetic resonance cholangiopancreatography?

Journal of the American College of Surgeons
Kenneth R Sirinek, Wayne H Schwesinger

Abstract

Preoperative ERCP, magnetic resonance cholangiopancreatography (MRCP), and intraoperative cholangiography (IOC) are standard procedures in evaluating patients with suspected choledocholithiasis. This study evaluates the changing practice patterns over time of these 3 procedures in a large cohort of patients undergoing laparoscopic cholecystectomy (LC) at a single tertiary care center. Data from all patients undergoing an LC with or without preoperative ERCP, MRCP, or an IOC from January 1, 2004 to December 31, 2013 were retrospectively reviewed from billing data obtained by CPT code and analyzed by chi-square testing. During 10 years, 7,427 patients underwent successful LC. The number of patients undergoing successful IOC (11.9% to 7.6%) or preoperative ERCP (7.2% to 1.5%) decreased significantly during that time interval (p < 0.01). In the last 6 years, 4,506 patients underwent successful LC. The number of patients from this group undergoing a preoperative MRCP (0.9% to 8.6%) or MRCP and ERCP (0.4% to 3.6%) increased significantly (p < 0.001). Despite a shift from IOC and preoperative ERCP to preoperative MRCP alone or with ERCP, a significant percentage (7.6%) of patients still underwent IOC in 2013. Use of IOC during LC has ...Continue Reading

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Citations

Apr 14, 2016·Journal of the American College of Surgeons·Kenneth R SirinekWayne H Schwesinger
Jul 24, 2015·Surgical Endoscopy·Nuria Estellés VidaganyFrancisco Blanes Masson
Mar 13, 2019·AJR. American Journal of Roentgenology·Jesse E ChenDavid Sarkany
Sep 12, 2019·World Journal of Surgery·Arnold BarriosDiego Orejuela
Sep 7, 2018·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Ying LuoYu Zhang
May 26, 2017·Case Reports in Gastrointestinal Medicine·Joseph BozzayCarlos J Rodriguez
Jun 12, 2021·World Journal of Emergency Surgery : WJES·Nicola de'AngelisDaniele Sommacale

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