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April 2, 2003

Routine vs Selective Intraoperative Cholangiography During Cholecystectomy

Author Affiliations

Author Affiliation: Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Md.

JAMA. 2003;289(13):1691-1692. doi:10.1001/jama.289.13.1691

The issue of routine vs selective intraoperative cholangiography (IOC) during cholecystectomy has been controversial for decades.1 During the era of open cholecystectomy, a policy of performing selective IOC during cholecystectomy had largely become accepted based on criteria regarding preoperative and operative clinical findings.2 The advent of safe and effective endoscopic-retrograde cholangiopancreatography and its ability to help the surgeon detect and treat common bile duct (CBD) stones was beginning to change the practice of IOC when laparoscopic cholecystectomy transformed the field of biliary tract surgery.3 Prior to the advent of laparoscopic cholecystectomy, some surgeons recommended routine use of IOC,4 but the common practice among surgeons was selective use of IOC.5 When laparoscopic cholecystectomy emerged, this debate was re-energized.6,7

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