OPERATIVE CHOLANGIOGRAPHY: A PERSPECTIVE

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Abstract
Two hundred and eighty-seven patients having operative cholangiograms were identified from a prospective study of 346 patients undergoing surgery for gallstones. Forty-two patients (14.6%) had filling defects and bile duct (BD) exploration. The false-positive exploration rate was 2.8%. Eight patients (2.8%) had unexpected BD calculi with no abnormality in pre-operative liver function tests or ultrasound. If a policy of selective operative cholangiography is pursued, then failure to detect a small number of duct stones must be expected, although unnecessary duct exploration is likely to be eliminated. The clinical significance of undetected BD calculi remains debatable.

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