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July 1969

Operative Cholangiography

Author Affiliations

Rosario, Argentina; Boston
From Cátedra de Clínica Quirúrgica de la Facultad de Ciencias Médicas de la Universidad Nacional del Litoral, Rosario, Argentina (Drs. Acosta, Fotheringham, and Ruiz), and the Department of Surgery, Massachusetts General Hospital, Boston (Dr. Nardi). Dr. Acosta is now also affiliated with Hospital "Dr. J. M. M. Fernandez," Granadero Baigorria, Santa Fe, Argentina; Dr. Fotheringham is now at Sanatorio Parque, Rosario, Argentina; and Dr. Ruiz is now at Siderurgia Argentina, Barrio Residensial, Los Aromos, San Nicolas, Argentina.

Arch Surg. 1969;99(1):29-32. doi:10.1001/archsurg.1969.01340130031006

To explore or not to explore the common bile duct during a cholecystectomy is an alternative which must be resolved by all who perform this operation. The complications resulting from an error in judgement in this decision have been well pointed out.1,2 An example of the earnest desire to avoid such errors is the paper of Bartlett et al,3 who have studied the predictability of the presence of common bile duct stones on the basis of certain clinical variables. However, despite all such precautions, most authors agree that not only is the incidence of residual stones at least 10%,2,4,5 but 50% of choledochostomies prove not to have been necessary.

In 1931 Mirizzi6 first proposed a new method for exploring the biliary tract during an operation which he called operative cholangiography. Experience with and without this technique has resulted in innumerable controversial publications2,4-9 and, as well,

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