Colangiografia transoperatória em colecistectomia laparoscópica

With laparoscopic cholecystectomy, the intraoperative cholangiography has been motive of intense controversy. Some authors perform it routinely. They consider laparoscopic cholecystectomy only an alternative to open access and, in that case, must be the same as conventional procedure. On the other hand, many authors believe that few patients have a true indication to evaluate the biliary tree. These authors do selectively intraoperative cholangiography. We performed 309 laparoscopic cholecystectomies between may 1993 and june 1997. The records of these patients were reviewed. Our results and experience with intraoperative cholangiography are evaluated. We usually perform intraoperative cholangiography by cystic duct catheterization, whenever feasible and without risk of injury to the biliary tree. It was possible in 244 (78.9%) cases. The main cause of unsuccessful was the presence of narrow cystic duct and occurred in 21 (6.8%) patients. The exam was normal in 229 (93.8%). Unsuspected choledocholithiasis was detected in six (2.4%), cystic duct draining into right hepatic duct was present in three (J.2%)and one (0.4%) had a choledocal cyst. The intraoperative cholangiography was a safe procedure in our patients who underwent laparoscopic cholecystectomy and, with our results, we recommend your routinely employment.