August 1974

Operative Cholangiography in a Rural Surgical Practice

Author Affiliations

From the Jackson County Schneck Memorial Hospital, Seymour, Ind (Dr. C. Wiethoff); Washington County Hospital, Salem, Ind (Dr. C. Wiethoff); and Marion County General Hospital, Indiana University Medical Center, Indianapolis (Drs. R. Wiethoff and Glover).

Arch Surg. 1974;109(2):254-256. doi:10.1001/archsurg.1974.01360020116022

Operative cholangiography was routinely performed during 826 cholecystectomies carried out by one physician in a private surgical practice in rural Indiana between January 1962 and January 1973. The technique of cholangiography, which involves two injections into the gallbladder neck, avoids cystic duct cannulation and adds no more than five minutes to the operating time.

Statistical data were derived from the records of 547 patients observed from one to ten years. Choledochotomy was done in 127 (23%) of these patients, yielding stones in 103 (80%) and other lesions in 19 (16%). Explorations based on abnormal roentgenographic findings yielded no stones in five patients (4% of explorations and 0.9% of roentgenograms), and stones were found in the ducts of two patients in spite of normal roentgenograms (2% and 0.4%).

Totally unsuspected stones were found in nine patients (representing 7% of the duct explorations). These data are similar to those reported by others. The new technique of cholangiography via the gallbladder neck is highly recommended.