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The Management of Gallstone Disease pp 249–262Cite as

Intraoperative Cholangiography

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Abstract

During intraoperative cholangiography (IOC), radio-opaque contrast is injected into the biliary tree in order to delineate the internal anatomy of the biliary tract from intrahepatic origins to termination at the choledocho-duodenal junction. Its purpose is to visualize structural anatomical variations or morphologic abnormalities (gallstones, strictures or possible bile duct injury) that may aid the decision-making and intervention during surgery or help guide further postoperative investigation or intervention.

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References

  1. Reich A. Accidental injection of bile ducts with petrolatum and bismuth paste. JAMA. 1918;71:1555.

    Article  Google Scholar 

  2. MacFadyen BV. Intraoperative cholangiography: past, present, future. Surg Endosc. 2006:S436–40.

    Article  Google Scholar 

  3. Mirizzi PL. La cholangiografia durante las operaciones de las vias biliares. Bol Soc Cir Buenos Aires. 1932;16:1113.

    Google Scholar 

  4. Puente SG, Bannura GC. Radiological anatomy of the biliary tract: variations and congenital abnormalities. World J Surg. 1983;7:271–6.

    Article  CAS  Google Scholar 

  5. Mortele KJ, Rocha TC, Streeter JL, Taylor AJ. Multimodality imaging of pancreatic and biliary congenital anomalies. Radiographics. 2006;26(3):715–32.

    Article  Google Scholar 

  6. Friedman AC, Sachs L. Embryology, anatomy, histology, and radiologic anatomy. In: Friedman AC, editor. Radiology of the liver, biliary tract, pancreas, and spleen. Baltimore, MD: Williams & Wilkins; 1987. p. 305–32.

    Google Scholar 

  7. Shaw MJ, Dorsher PJ, Vennes JA. Cystic duct anatomy: an endoscopic perspective. Am J Gastroenterol. 1993;88:2102–6.

    CAS  PubMed  Google Scholar 

  8. Sinnatamby CS. Last’s anatomy: regional and applied. North Miami Beach, FL: Churchill Livingstone; 1999. ISBN: 0443056110.

    Google Scholar 

  9. Perret RS, Sloop GD, Borne JA. Common bile duct measurements in an elderly population. J Ultrasound Med. 2000;19:727–30.

    Article  CAS  Google Scholar 

  10. Lal N, Mehra S, Lal V. Ultrasonographic measurement of normal common bile duct diameter and its correlation with age, sex, and anthropometry. J Clin Diagn Res. 2014;8(12):AC01–4.

    PubMed  PubMed Central  Google Scholar 

  11. Wu CC, Ho YH, Chen CY. Effect of aging on common bile duct diameter: a real-time ultrasonographic study. J Clin Ultrasound. 1984;12(8):473–8.

    Article  CAS  Google Scholar 

  12. Senturk S, Miroglu TC, Bilici A, Gumus H, Tekin RC, Ekici F, Tekbas G. Diameters of the common bile duct in adults and postcholecystectomy patients: a study with 64-slice CT. Eur J Radiol. 2012;81(1):39–42.

    Article  Google Scholar 

  13. Laing FC. The gallbladder and bile ducts. In: Rumack C, Wilson S, Carboneau JW, editors. Diagnostic ultrasound. St Louis, MO: Mosby; 1998. p. 207.

    Google Scholar 

  14. Castelain M, Grimaldi C, Harris AG, Caroli-Bosc F-X, Hastier P, Dumas R, Delmont J-P. Relationship between cystic duct diameter and the presence of cholelithiasis. Dig Dis Sci. 1993;38(12):2220–4.

    Article  CAS  Google Scholar 

  15. McCammon RL, Stoelting R, Madura JA. Surg Gynecol Obstet. 1983;156(3):329–34.

    CAS  PubMed  Google Scholar 

  16. Jones RM, Coultas RM, Pollard BJ, Waterland JW. Anaesth Intensive Care. 1983;11(2):174–5.

    CAS  PubMed  Google Scholar 

  17. Setakis N, Vennart W, Gardner AM, Nayak P. A peroperative test of the function of the sphincter of Oddi. Ann R Coll Surg Engl. 1984;66(3):175–8.

    CAS  PubMed  PubMed Central  Google Scholar 

  18. Martin CJ, Vaccaro L, Cox MR. Transcystic stenting for the management of common bile duct stones at laparoscopic cholecystectomy. Aust N Z J Surg. 2002;72:258–64.

    Article  Google Scholar 

  19. Collins C, Maguire D, Ireland A, Fitzgerald E, O’Sullivan GC. A prospective study of common bile duct calculi in patients undergoing laparoscopic cholecystectomy. Natural history of choledocholithiasis revisited. Ann Surg. 2004;239:28–33.

    Article  PubMed Central  Google Scholar 

  20. Sarli L, Costi R, Roncoroni L. Intraoperative cholangiography and bile duct injury. Surg Endosc. 2006;20:176–7.

    Article  CAS  Google Scholar 

  21. Buddingh KT, Morks AN, ten Cate Hoedemaker HO, Blaauw CB, van Dam GM, Ploeg RJ, Hofker HS, Niewenhuijs VB. Documenting correct assessment of biliary anatomy during laparoscopic cholecystectomy. Surg Endosc. 2012;26:79–85.

    Article  CAS  Google Scholar 

  22. Buddingh KT, Weersma RK, Savenije RAJ, van Dam GM, Nieuwenhuijs VB. Lower rate of major bile duct injury and increased intraoperative management of common bile duct stones after implementation of routine intraoperative cholangiography. J Am Coll Surg. 2011;213:267–74.

    Article  Google Scholar 

  23. Strasberg SM, Herti M, Soper NJ. An analysis of the problem of biliary injury during laparoscopic cholecystectomy. J Am Coll Surg. 1995;180(1):101–25.

    CAS  Google Scholar 

  24. Dalton SJ, Balupuri S, Guest J. Routine magnetic resonance cholangiopancreatography and intra-operative cholangiogram in the evaluation of common bile duct stones. Ann R Coll Surg Engl. 2005;87:469–70.

    Article  CAS  PubMed Central  Google Scholar 

  25. Ludwig K, Bernhardt J, Steffen H, Lorenz D. Contribution of intraoperative cholangiography to incidence and outcome of common bile duct injuries during laparoscopic cholecystectomy. Surg Endosc. 2002;16:1098–104.

    Article  CAS  Google Scholar 

  26. Flum DR, Dellinger EP, Cheadle CL, Koepsell T. Intraoperative cholangiography and risk of common bile duct injury during cholecystectomy. JAMA. 2003;289:1639–44.

    Article  Google Scholar 

  27. Waage A, Nilsson M. Iatrogenic bile duct injury. A population-based study of 152 776 cholecystectomies in the Swedish inpatient registry. Arch Surg. 2006;141:1207–13.

    Article  Google Scholar 

  28. Törnqvist B, Strömberg C, Persson G, Nilsson M. Effect of intended intraoperative cholangiography and early detection of bile duct injury no survival after cholecystectomy: population-based cohort study. BMJ. 2012;345:e6457. https://doi.org/10.1136/bmj.e6457.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Fletcher DR, Hobbs MST, Tan P, Valinsky LJ, Hockey RL, Pikora TJ, Knuiman MW, Sheiner HJ, Edis A. Complications of cholecystectomy: risks of the laparoscopic approach and protective effects of operatie cholangiography. Ann Surg. 1999;229(4):449–57.

    Article  CAS  PubMed Central  Google Scholar 

  30. Nuzzo G, Giuliante F, Giovannini I, Ardito F, D’Acapito F, Vellone M, Murazio M, Capelli G. Bile duct injury during laparoscopic cholecystectomy. Results of an Italian national survey on 56 591 cholecystectomies. Arch Surg. 2005;140:986–92.

    Article  Google Scholar 

  31. Giger U, Ouaissi M, Schmitz S-FH, Krähenbühl S, Krähenbühl L. Biel duct injury and use of cholagiography during laparoscopic cholecystectomy. Br J Surg. 2011;98:391–6.

    Article  CAS  Google Scholar 

  32. Sheffield KM, Riall TS, Han Y, Kuo Y-F, Townsend CM, Goodwin JS. Association between cholecystectomy with vs without intraoperative cholangiography and risk of common duct injury. JAMA. 2013;310(8):812–20.

    Article  CAS  PubMed Central  Google Scholar 

  33. Traverso W. Intraoperative cholangiography lowers the risk of bile duct injury during cholecystectomy. Surg Endosc. 2006;20:1659–61.

    Article  CAS  Google Scholar 

  34. Hillis TM, Westbrook KC, Caldwell FT, Read RC. Surgical injury of the common bile duct. Am J Surg. 1977;134(6):712–6.

    Article  CAS  Google Scholar 

  35. Nathanson LK, O’Rourke NA, Martin IJ, Fielding GA, Cowen AE, Roberts RK, Kendall BJ, Kerlin P, Devereux BM. Postopertive ERCP versus laparoscopic choledochotomy for clearance of selected bile duct calculi: a randomized trial. Ann Surg. 2005;242(2):188–92.

    Article  PubMed Central  Google Scholar 

  36. Poh BR, Ho SPS, Sritharan M, Yeong CC, Swan MP, Devonshire DA, Cashin PA, Croagh DG. Randomized clinical trial of intraoperative endoscopic retrograde cholangiopancreatography versus laparoscopic bile duct exploration in patients with choledocholithiasis. Br J Surg. 2016;103:1117–24.

    Article  CAS  Google Scholar 

  37. Slater K, Strong RW, Wall DR, Lynch SV. Iatrogenic bile duct injury: the scourge of laparoscopic cholecystectomy. ANZ J Surg. 2002;72:83–8.

    Article  CAS  Google Scholar 

  38. Woods MS, Traverso LW, Kozarek RA, Tsao J, Rossi RL, Gough D, Donohue JH. Characteristics of biliary tract complications during laparoscopic cholecystectomy: a multi-institutional study. Am J Surg. 1994;167(1):27–33.

    Article  CAS  Google Scholar 

  39. Connor SJ, Perry W, Nathanson L, Hugh TB, Hugh TJ. Using a standardized method for laparoscopic cholecystectomy to create a concept operation-specific checklist. HPB. 2014;16(5):422–9.

    Article  Google Scholar 

  40. Strasberg SM, Sanabria JR, Clavien PA. Complications of laparoscopic cholecystectomy. Can J Surg. 1992;35:275–80.

    CAS  Google Scholar 

  41. Eshghi F, Abdi R. Routine magnetic resonance cholangiography compared to intra-operative chlangiography in patients with suspected common bile duct stoens. Hepatobiliary Pancreat Dis Int. 2008;7:525–8.

    PubMed  Google Scholar 

  42. Srinivasa S, Sammour T, McEntee B, Davis N, Hill AG. Selective use of magnetic resonance chilangiopancreatography in clinical practice may miss choledocholithiasis in gallstone pancreatitis. Can J Surg. 2010;53(6):403–7.

    PubMed  PubMed Central  Google Scholar 

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Author information

Authors and Affiliations

  1. Theme Cancer, PA Upper Abdomen, PF Pancreas, K53, Karolinska University Hospital, Stockholm, Sweden

    Elena Rangelova M.D.

  2. Division of Surgery, Department of Clinical Science, Intervention, and Technology (CLINTEC), Karolinska Institute, Stockholm, Sweden

    Elena Rangelova M.D.

  3. Flinders Medical Centre, Southern Adelaide Local Health Network, Bedford Park, SA, Australia

    Robert Padbury

Authors
  1. Elena Rangelova M.D.
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  2. Robert Padbury
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Corresponding authors

Correspondence to Elena Rangelova M.D. or Robert Padbury .

Editor information

Editors and Affiliations

  1. Professor of Surgery, Nepean Clinical School University of Sydney, Sydney, NSW, Australia

    Michael R. Cox

  2. Discipline of Surgery, The Whiteley-Martin Research Centre, University of Sydney, Sydney, NSW, Australia

    Guy D. Eslick

  3. Divisional Director of Surgery, Flinders Medical Centre, Adelaide, SA, Australia

    Robert Padbury

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Rangelova, E., Padbury, R. (2018). Intraoperative Cholangiography. In: Cox, M., Eslick, G., Padbury, R. (eds) The Management of Gallstone Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-63884-3_17

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  • DOI: https://doi.org/10.1007/978-3-319-63884-3_17

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-63882-9

  • Online ISBN: 978-3-319-63884-3

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