A review of the modern literature on the role of cholangiography in biliary tract surgery leads to the following conclusions: (1) Since approximately 10% of patients who harbor common duct stones do not present the common clinical indications for choledochotomy, cholangiography should be performed routinely in all operations on the biliary tree before deciding for or against common duct exploration. (2) Since false negatives occasionally occur, a negative cholangiogram should not prevent choledochotomy if strong clinical or intraoperative indications are present. (3) Since the incidence of retained stones after choledochotomy can range as high as 30%, intraoperative completion cholangiography should be routinely performed after choledochotomy.
Isch JH. Operative CholangiographyThe Case for Its Broadened Use in Biliary Tract Surgery. Arch Surg. 1973;107(1):106-110. doi:10.1001/archsurg.1973.01350190088026