Citation Information :
Fazzotta S, Genova G, Pantuso G, Buscemi S, Palumbo VD, Damiano G, Monte AI, Genova P. Intraoperative Cholangiography during Cholecystectomy Using a Biliary-nose Tube: Routinely Used in Patients with Main Bile Duct Stones. World J Lap Surg 2021; 14 (1):15-19.
Background: Nowadays, the “gold standard” treatment for gallbladder stones is laparoscopic cholecystectomy but the risk of iatrogenic biliary duct injuries is increased compared to “open” surgery. Intraoperative cholangiography (IOC) can be useful to avoid biliary injuries but it can also be a no-safe procedure in center in which it is not routinely performed.
Aim and objective: The aim of our study is to trust the efficacy of IOC in a patient with common bile duct (CBD) and gallbladder stones using a biliary-nose tube.
Materials and methods: 135 patients with gallbladder and CBD stones were treated with sequential therapy and randomly divided into two groups. Laparoscopic cholecystectomy was performed within 24/48 h. During endoscopic retrograde cholangiopancreatography, a biliary-nose catheter was left to perform cholangiography during the following surgical procedure. Group A had also a cholangiography at the beginning of the surgical procedure in order to evidence biliary duct structure.
Results: Cholangiography avoided a lesion of the biliary ducts in nine patients. Only a patient had a residual stone in the CBD. The dissection at Calot\'s triangle was faster in group A patients without differences between the surgeons involved.
Conclusion: The biliary-nose tube can be useful in patients with gallbladder and CBD who underwent cholecystectomy for different reasons: it lets the surgeon performing IOC faster and without risk linked to the technique used; it reduces the risk of biliary injuries; and surgeons feel more safe and calm during the surgical procedure.
Kholdebarin R, Boetto J, Harnish JL, et al. Risk factors for bile duct injury during laparoscopic cholecystectomy: a case-control study. Surg Innov 2008;15(2):114–119. DOI: 10.1177/1553350608318144.
Nuzzo G, Giuliante F, Giovannini I, et al. Bile duct injury during laparoscopic cholecystectomy: results of an Italian National Survey on 56 591 cholecystectomies. Arch Surg 2005;140(10):986–992. DOI: 10.1001/archsurg.140.10.986.
Archer SB, Brown DW, Smith CD, et al. Bile duct injury during laparoscopic cholecystectomy: results of a national survey. Ann Surg 2001;234(4):549–558. DOI: 10.1097/00000658-200110000-00014.
Ress AM, Sarr MG, Nagorney DM, et al. Spectrum and management of major complications of laparoscopic cholecystectomy. Am J Surg 1993;165(6):655–662. DOI: 10.1016/s0002-9610(05)80783-4.
Strasberg SM, Hertl M, Soper NJ. An analysis of the problem of biliary injury during laparoscopic cholecystectomy. J Am Coll Surg 1995;180(5):638–639. PMID: 8000648
Way LW, Stewart L, Gantert W, et al. Causes and prevention of laparoscopic bile duct injuries: analysis of 252 cases from a human factors and cognitive psychology perspective. Ann Surg 2003;237(4):460–469. DOI: 10.1097/01.SLA.0000060680.92690.E9.
Boerma D, Rauws EAJ, Keulemans YCA, et al. Impaired quality of life 5 years after bile duct injury during laparoscopic cholecystectomy: a prospective analysis. Ann Surg 2001;234(6):750–757. DOI: 10.1097/00000658-200112000-00006.
Moore DE, Feurer ID, Holzman MD, et al. Long-term detrimental effect of bile duct injury on health-related quality of life. Arch Surg 2004;139(5):476–482. DOI: 10.1001/archsurg.139.5.476.
Mirizzi PL. La colangiografia operatoria [Operative cholangiography]. Rev Esp Enferm Apar Dig Nutr. 1950 May-Jun;9(3):306-8. Spanish. PMID: 15441389.
Colcock BP, Perey B. Exploration of the common bile duct. Surg Gynecol Obstet 1964;118:20–24. Available from: http://www.ncbi.nlm.nih.gov/pubmed/14105849.
Millat B, Deleuze A, de Saxce B, et al. Routine intraoperative cholangiography is feasible and efficient during laparoscopic cholecystectomy. Hepatogastroenterology 1997;44(13):22–27. PMID: 9058113
Massarweh NN, Flum DR. Role of intraoperative cholangiography in avoiding bile duct injury. J Am Coll Surg 2007;204:656–664. DOI: 10.1016/j.jamcollsurg.2007.01.038.
Girard RM, Legros G. Retained and recurrent bile duct stones. Surgical or nonsurgical removal? Ann Surg 1981;193(2):150–154. Available from: http://www.ncbi.nlm.nih.gov/pubmed/7469550.
Stark ME, Loughry CW. Routine operative cholangiography with cholecystectomy. Surg Gynecol Obstet. 1980;151(5):657–658. Available from: http://www.ncbi.nlm.nih.gov/pubmed/7434175.
Katon RM, Lee TG, Parent JA, et al. Endoscopic retrograde cholangiopancreatography (ERCP). Experience with 100 cases. Am J Dig Dis. 1974;19(4):295–306. Available from: http://www.ncbi.nlm.nih.gov/pubmed/4821307.
Branum G, Schmitt C, Baillie J, et al. Management of major biliary complications after laparoscopic cholecystectomy. Ann Surg 1993;217(5):532–541. Available from: http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L23149828.
Buddingh KT, Nieuwenhuijs VB, Van Buuren L, et al. Intraoperative assessment of biliary anatomy for prevention of bile duct injury: a review of current and future patient safety interventions. Surg Endosc 2011;25:2449–2461. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21487883.
Richardson MC, Bell G, Fullarton GM. Incidence and nature of bile duct injuries following laparoscopic cholecystectomy: an audit of 5913 cases. Br J Surg 1996;83(10):1356–1360. DOI: 10.1002/bjs.1800831009.
Pucher PH, Brunt LM, Fanelli RD, et al. SAGES expert Delphi consensus: critical factors for safe surgical practice in laparoscopic cholecystectomy. Surg Endosc 2015;29(11):3074–3085. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25669635
Bingham J, McKie LD, McLoughlin J, et al. Biliary complications associated with laparoscopic cholecystectomy - an analysis of common misconceptions. Ulster Med J 2000;69(2):106–111. PMID: 11196720; PMCID: PMC2449182.
Connor SJ, Perry W, Nathanson L, et al. Using a standardized method for laparoscopic cholecystectomy to create a concept operation-specific checklist. HPB 2014;16(5):422–429. DOI: 10.1111/hpb.12161.
Slim K, Martin G. Does routine intra-operative cholangiography reduce the risk of biliary injury during laparoscopic cholecystectomy? An evidence-based approach. J Visc Surg 2013;150:321–324. DOI: 10.1016/j.jviscsurg.2013.06.002.
Yeh BM, Liu PS, Soto JA, et al. MR imaging and CT of the biliary tract. Radiographics 2009;29(6):1669–1688. DOI: 10.1148/rg.296095514.
Sugiyama M, Atomi Y. Follow-up of more than 10 years after endoscopic sphincterotomy for choledocholithiasis in young patients. Br J Surg 1998;85(7):917–921. DOI: 10.1046/j.1365-2168.1998.00750.x.
Nickkholgh A, Soltaniyekta S, Kalbasi H. Routine versus selective intraoperative cholangiography during laparoscopic cholecystectomy: a survey of 2,130 patients undergoing laparoscopic cholecystectomy. Surg Endosc Other Interv Tech 2006;20(6):868–874. DOI: 10.1007/s00464-005-0425-x.
Palumbo VD, Di Trapani B, Bruno A, et al. Recurrent retroperitoneal abscess after biliary tract surgery in an elderly patient: a minimally invasive nonsurgical approach and its consequences: a case report. J Med Case Rep 2019;13(1):43. DOI: 10.1186/s13256-019-1973-3.
Fazio V, Damiano G, Palumbo VD, et al. An unexpected surprise at the end of a ‘Quiet’ cholecystectomy. A case report and review of the literature. Ann Ital Chir 2012;83:265–268. PMID: 22595736
Bonventre G, Di Buono G, Buscemi S, et al. Laparoscopic management of cholecystocolonic fistula: a case report and a brief literature review. Int J Surg Case Rep 2020;68:218–220. DOI: 10.1016/j.ijscr.2020.02.052.
Williams E, Beckingham I, El Sayed G, et al. Updated guideline on the management of common bile duct stones (CBDS). [cited 2020 Apr 28]; Available from: http://gut.bmj.com/.
Boulay J, Schellenberg R, Brady PG. Role of ERCP and therapeutic biliary endoscopy in association with laparoscopic cholecystectomy. Am J Gastroenterol 1992;87(7):837–842. Available from: http://www.ncbi.nlm.nih.gov/pubmed/1535478.
Sajid MS, Leaver C, Haider Z, et al. Routine on-table cholangiography during cholecystectomy: a systematic review. Ann R Coll Surg Engl 2012; 94:375–380. DOI: 10.1308/003588412X13373405385331.
Giger U, Ouaissi M, Schmitz SFH, et al. Bile duct injury and use of cholangiography during laparoscopic cholecystectomy. Br J Surg 2011;98(3):391–396. DOI: 10.1002/bjs.7335.
Soper NJ, Brunt LM. The case for routine operative cholangiography during laparoscopic cholecystectomy. Surg Clin N Am 1994;74:953–959. DOI: 10.1016/S0039-6109(16)46397-8.
Gigot JF, Etienne J, Aerts R, et al. The dramatic reality of biliary tract injury during laparoscopic cholecystectomy: an anonymous multicenter Belgian survey of 65 patients. Surg Endosc 1997;11(12):1171–1178. DOI: 10.1007/s004649900563.
Eikermann M, Siegel R, Broeders I, et al. Prevention and treatment of bile duct injuries during laparoscopic cholecystectomy: the clinical practice guidelines of the European Association for Endoscopic Surgery (EAES). Surg Endosc 2012;26(11):3003–3039. DOI: 10.1007/s00464-012-2511-1.
Strasberg SM, Brunt LM. Rationale and use of the critical view of safety in laparoscopic cholecystectomy. J Am Coll Surg 2010;211(1):132–138. DOI: 10.1016/j.jamcollsurg.2010.02.053.
Strasberg MS. A perspective on the critical view of safety in laparoscopic cholecystectomy. Ann Laparosc Endosc Surg. 2017;2(5):91. DOI: 10.21037/ales.2017.04.08.
Agrusa A, Di Buono G, Buscemi S, et al. 3D laparoscopic surgery: a prospective clinical trial. Oncotarget 2018;9(25):17325–17333. DOI: 10.18632/oncotarget.24669.
Fletcher DR, Hobbs MST, Tan P, et al. Complications of cholecystectomy: risks of the laparoscopic approach and protective effects of operative cholangiography: a population-based study. Ann Surg 1999;229:449–457. DOI: 10.1097/00000658-199904000-00001.
Ludwig K, Bernhardt J, Steffen H, et al. Contribution of intraoperative cholangiography to incidence and outcome of common bile duct injuries during laparoscopic cholecystectomy. Surg Endosc Other Interv Tech 2002;16(7):1098–1104. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12165830.
Soper NJ, Dunnegan DL. Routine versus selective intra-operative cholangiography during laparoscopic cholecystectomy. World J Surg 1992;16(6):1133–1140. DOI: 10.1007/BF02067079.
Lorimer JW, Fairfull-Smith RJ. Intraoperative cholangiography is not essential to avoid duct injuries during laparoscopic cholecystectomy. Am J Surg 1995;169(3):344–347. DOI: 10.1016/S0002-9610(99)80173-1.
Flum DR, Dellinger EP, Cheadle A, et al. Intraoperative cholangiography and risk of common bile duct injury during cholecystectomy. J Am Med Assoc 2003;289(13):1639–1644. DOI: 10.1001/jama.289.13.1639.
Livingston EH, Miller JAG, Coan B, et al. Costs and utilization of intraoperative cholangiography. J Gastrointest Surg 2007;11(9):1162–1167. DOI: 10.1007/s11605-007-0209-9.
Flum DR, Flowers C, Veenstra DL. A cost-effectiveness analysis of intraoperative cholangiography in the prevention of bile duct injury during laparoscopic cholecystectomy. J Am Coll Surg 2003;196(3):385–393. DOI: 10.1016/S1072-7515(02)01806-9.
Lillemoe KD, Yeo CJ, Talamini MA, et al. Selective cholangiography: current role in laparoscopic cholecystectomy. Ann Surg 1992;315:669–676. DOI: 10.1097/00000658-199206000-00014.