PMID: 1203653Dec 1, 1975Paper

Operative cholangiography: a reappraisal based on a review of 400 cholangiograms

The British Journal of Surgery
I FarisL P Le Quesne

Abstract

In the period 1957-72, 426 patients were operated upon for calculous disease of the biliary tract. For various reasons pre-exploratory operative cholangiography was not performed in 26 patients, but in the remaining 400 patients this examination was the major determinant as to whether or not the common duct contained calculi, and hence required exploration. Analysis of this series of 400 patients shows that without operative cholangiography (a) ductal stones would have been overlooked in 16 of the 78 patients with stones in the common duct (4 per cent of the whole series; 20-5 per cent of those with stones in the common bile duct); (b) exploration of the common duct would have been required in a further 48 (15 per cent) of the 322 patients without stones in the common duct, giving a positive yield from operative cholangiography in 64 patients (16 per cent) in the whole series. Negative exploration of the common duct was performed in only 31 patients, that is 29 per cent of the patients whose duct was explored but only 7-8 per cent of the whole group. The criteria by which an operative cholangiogram should be assessed were re-evaluated in the light of the findings in these 400 patients. In general the criteria of normality previ...Continue Reading

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