Operative cholangiography performed during laparoscopic cholecystectomy

Abstract

Operative cholangiography is an important adjunct to laparoscopic cholecystectomy, a recently developed surgical procedure in which cholecystectomy is performed through four abdominal ports under sustained pneumoperitoneum and the direct vision of a video laparoscope. Operative cholangiogram can effectively identify incidental choledocholithiasis or anatomic variation in the biliary system that may significantly influence the surgical approach or postoperative management of the patient. Unique features portrayed on operative cholangiogram in patients undergoing laparoscopic cholecystectomy include unusual displays of pneumoperitoneum, subcutaneous emphysema, visualization of the unresected gallbladder, and overlying surgical hardware that must remain in the operating field during film exposure.