TITLE

Indicated Cholangiography in Patients Operated on by Routine versus Selective Cholangiographers

AUTHOR(S)
Kohn, Annemarie; Creech, Steve; Shayani, Vafa
PUB. DATE
March 2004
SOURCE
American Surgeon;Mar2004, Vol. 70 Issue 3, p203
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Intraoperative cholangiography (IOC) remains a subject of much debate among laparoscopic surgeons. When IOC is indicated, the surgeon's preference for routine cholangiography (RC) or selective cholangiography (SC) may have an impact on the outcome of IOC and cholecystectomy. Hereafter, we present our experience with cholangiography in patients with clear indications for IOC when operated on by surgeons favoring SC versus RC. Between January 1, 1999, and December 1, 2000, 389 patients underwent laparoscopic cholecystectomy at Loyola University Medical Center. One hundred fifty-one patients had indication for IOC (jaundice, pancreatitis, increased liver function tests (LFTs), abnormal anatomy, ductal dilatation, or ductal stones identified on preoperative ultrasound), and they constitute the sample for this study. The results of IOC and subsequent outcome of cholecystectomy were reviewed using the electronic medical database. Thirty-nine patients, were operated on by 2 surgeons favoring RC and 112 by 12 favoring SC. Patient demographics were similar in both groups. Only 30 (27%) of the SC group had attempted IOC with 28 successful IOCs (25% of all patients). In contrast, 38 (97%) of the RC group had successful IOC, which was significantly higher than the SC group (P < 0.0001 by X² test). Adverse events included conversions to open, postoperative endoscopic retrograde cholangiopancreatography, bile leak, repeat operative intervention, pancreatitis, elevated LFTs, intraabdominal and wound infection, prolonged emesis, and persistent abdominal pain. Two (5%) adverse events occurred in the RC group, which was significantly less than the 33 (30%) adverse events in the SC group (P = 0.002 by X² test). Conversions to open were significantly less in the RC group, with no conversions in the RC group and 20 (18%) in the SC group (P = 0.005). There were no mortalities in this series. In a univariate analysis, age and gender did not correlate with increased risk...
ACCESSION #
12619034

 

Related Articles

  • Complementary role of helical CT cholangiography to MR cholangiography in the evaluation of biliary function and kinetics. Eracleous, Eleni; Genagritis, Marios; Papanikolaou, Nicos; Kontou, Allayioti; Prassopoullos, P.; Chrysikopoulos, Haris; Allan, Paul; Gourtsoyiannis, Nicholas; Kontou, Allayioti Maria // European Radiology;Oct2005, Vol. 15 Issue 10, p2130 

    To explore the potential role of computed tomographic cholangiography (CTC) in relation to magnetic resonance cholangiography (MRC) in cases in which knowledge of biliary kinetics and functional information are important for therapeutic decisions, 31 patients (14 men and 17 women) underwent MRC...

  • HPDI Table of Contents Vol. 13, No. 4, 2014.  // Digestive Surgery;Oct2014, Vol. 31 Issue 3, p246 

    No abstract available

  • Intraoperative cholangiography facilitates simple transcystic clearance of ductal stones in units without expertise for laparoscopic bile duct surgery. Hamouda, A.; Goh, W.; Mahmud, S.; Khan, M.; Nassar, A.; Hamouda, A H; Nassar, A H M // Surgical Endoscopy;Jun2007, Vol. 21 Issue 6, p955 

    Background: In the absence of facilities and expertise for laparoscopic bile duct exploration (LBDE), most patients with suspected ductal calculi undergo preoperative endoscopic duct clearance. Intraoperative cholangiography (IOC) is not performed at the subsequent laparoscopic...

  • Acetaminophen-Induced Pancreatic Pseudocyst: First Case Report. CAVANAUGH, ZACHARY; NAUT, EDGAR R. // Connecticut Medicine;Jan2014, Vol. 78 Issue 1, p37 

    Introduction: Acetaminophen is known for its toxic effects on hepatic cells. Moreover, acetaminophen toxicity in the setting of hepatic failure has also been associated with dysfunction and failure of other organ systems, including the pancreas. Drug-induced pancreatitis (DIP) is rare and has...

  • Laparoscopic posterior sectoral bile duct injury: the emerging role of nonoperative management with improved long-term results after delayed diagnosis. Perera, M. T. P. R.; Monaco, A.; Silva, M. A.; Bramhall, S. R.; Mayer, A. D.; Buckels, J. A. C.; Mirza, D. F. // Surgical Endoscopy;Aug2011, Vol. 25 Issue 8, p2684 

    Background: Right posterior sectoral bile duct (RPSD) anomalies seen in up to 8% of the population rarely are injured at laparoscopic cholecystectomy. Paucity of data on the management of these injuries led the authors to conduct this study aimed at reviewing management strategies for...

  • Pancreatic-Biliary Ascariasis: Experience of 300 Cases. Sandouk, Fayez; Haffar, Samir; Zada, Mazen M.; Graham, David Y.; Anand, Bhupinderjit S. // American Journal of Gastroenterology;Dec1997, Vol. 92 Issue 12, p2264 

    Background: Infestation with Ascaris lumbricoides is seen worldwide. Recently, there has been much interest in the pancreatic-biliary complications of Ascaris infection. In this study, we present our experience of 300 patients seen in a tertiary referral center. Materials and...

  • Spinal Cord Stimulation for Intractable Visceral Pain Due to Sphincter of Oddi Dysfunction. Kang Hun Lee; Sang Eun Lee; Jae Wook Jung; Sang Yoon Jeon // Korean Journal of Pain;Jan2015, Vol. 28 Issue 1, p57 

    Sphincter of Oddi dysfunction (SOD) is a syndrome of chronic biliary pain or recurrent pancreatitis due to the functional obstruction of the pancreaticobiliary flow. We report a case of spinal cord stimulation (SCS) for chronic abdominal pain due to SOD. The patient had a history of...

  • Pancreato-biliary Endoscopic Ultrasound in Opium Addicts Presenting with Abdominal Pain. Sharma, Shyam Sundar; Ram, Seva; Maharshi, Sudhir; Shankar, Vijay; Katiyar, Prashant; Jhajharia, Ashok; Sardava, Vimal; Bhardwaj, Hemendra // Endoscopic Ultrasound;Nov2013, Vol. 2 Issue 4, p204 

    The article focuses on the study done to examine the effects of Opium addiction that causes obstruction at ampulla and produces dilatation of bile duct and pancreatic duct (PD). Topics discussed include diagnosis of the dilated bile duct using endoscopic ultrasound (EUS), increase of the Surface...

  • The Role of ERCP in Patients after Laparoscopic Cholecystectomy. Pencev, Dobromir; Brady, Patrick G.; Pinkas, Haim; Boulay, Joseph // American Journal of Gastroenterology;Sep1994, Vol. 89 Issue 9, p1523 

    Objectives: The goal of this study was to evaluate the feasibility of endoscopic management of complications encountered in patients undergoing laparoscopic cholecystectomy. Special attention was given to establishing the optimal timing, success rate, and complications of diagnostic and...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics