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Intraoperative cholangiography in laparoscopic cholecystectomy during residency in general surgery.
- Source :
-
Surgical endoscopy [Surg Endosc] 2001 Aug; Vol. 15 (8), pp. 812-5. Date of Electronic Publication: 2001 May 11. - Publication Year :
- 2001
-
Abstract
- Background: The role of laparoscopic intraoperative cholangiography (IC) in the diagnosis of asymptomatic choledocholithiasis is still controversial. The aim of this study was to evaluate the diagnostic-therapeutic impact and the educational implications of this method for residents specializing in general surgery.<br />Methods: We reviewed the records of 835 patients who underwent laparoscopic cholecystectomy for cholecystolithiasis without choledocholithiasis. IC was routinely performed by both expert surgeons and residents in general surgery.<br />Results: The cholecystectomy was completed laparoscopically in 804 cases, but conversion to open surgery was required in 31 cases. IC was not completed in 140 cases (17.4%), and in 44 cases it revealed a suspected choledocholithiasis. The stones were treated via laparoscopy in 36 cases, laparotomy in six cases, and endoscopic retrograde cholangiopancreatography (ERCP) in two cases. Five patients were not diagnosed wit h choledocholithiasis. In one case, a lesion of the choledochus was discovered and treated laparoscopically. A total of 610 IC were done by expert surgeons and 225 by residents. The duration of the cholecystectomy with IC was significantly different between the two groups (76.9 +/- 12 vs 92.4 +/- 11), as was the feasibility index (88.6% vs 80.6%).<br />Conclusions: Laparoscopic IC is a safe and accurate procedure for the diagnosis of unrecognized choledocholithiasis. Teaching of this procedure as part of the specialization in general surgery would be opportune because it would provide surgical residents with an additional tool for the diagnosis and treatment of this pathology of the common bile duct.
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Cholangiopancreatography, Endoscopic Retrograde
False Positive Reactions
Female
Gallstones diagnostic imaging
Gallstones surgery
Humans
Italy
Male
Middle Aged
Monitoring, Intraoperative
Retrospective Studies
Cholangiography
Cholecystectomy, Laparoscopic education
General Surgery education
Internship and Residency
Subjects
Details
- Language :
- English
- ISSN :
- 1432-2218
- Volume :
- 15
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Surgical endoscopy
- Publication Type :
- Academic Journal
- Accession number :
- 11443457
- Full Text :
- https://doi.org/10.1007/s004640090006