INTRAOPERATIVE CHOLANGIOGRAPHY DURING LAPAROSCOPIC CHOLECYSTECTOMY: WHAT ROLE?

Aim: Laparoscopic cholecystectomy has increased the number of iatrogenic lesion of the biliary tree. In this study, we evaluate the role of intra-operative cholangiography in prevention of biliary tree iatrogenic lesions and early identification of choledocolithiasis, during laparoscopic cholecystectomy. Material of study: 169 patients who underwent laparoscopic cholecystectomy, were evaluated by means of intra-operative cholangiography. Patients were divided into two groups basing on the risk to develop biliary tree lithiasis. Discussion: Patients with a higher risk of postoperative complications effectively showed cholangiographic anomalies, including duct stones, dilations, anatomical variations, and iatrogenic lesions of the biliary tree. Intra-operative cholangioraphy avoided iatrogenic lesions, allowing the surgeon to recognize the anatomical structures of the biliary tree, even for unusual cases. Conclusions: Intra-operative cholangiography has still a role in preventing all above mentioned complications related to biliary tree laparoscopy, depicting perfectly the anatomy of the biliary tree and diagnosing common bile duct lithiasis during intervention, especially in selected cases with a higher risk to develop complications.