A Randomized Controlled Trial Comparing Intraoperative Cholangiography by Cystic Duct Cholangiography and Cholecystocholangiography During Laparoscopic Cholecystectomy

Abstract

Introduction: Intraoperative cholangiography (IOC) is an essential step during laparoscopic cholecystectomy for identifying common bile duct pathology. The conventional technique for intraoperative cholangiography is the cystic duct cannulation, which required laparoscopic skill. A puncture through the gallbladder is a less complicated technique.

Objective: To compare the success rate, operative time and postoperative complications between cholangiography via the cystic duct method and through the gallbladder method.

Methods: 86 patients who underwent IOC during laparoscopic cholecystectomy were randomized for the operation via either cystic duct cannulation or though gallbladder method. Success rate in cholangiography, operating time and complications were compared between the two groups.

Results: The success rate of cholangiography via cystic duct and trans-gallbladder route were 100% (43/43) and 90.7% (39/43), respectively (p=0.12). The average operating time for cholangiography through the cystic duct was longer than through the gallbladder (15.0 + 11.2 minutes and 8.9 + 6.7 minutes, (p <0.01). There was no complication in both groups.

Conclusion: The simple technique of cholangiography through the gallbladder was feasible and had a low risk of complication. Therefore, this technique may be recommended as an alternative method.