Biliary ductal anatomy and anomalies. The role of intraoperative cholangiography during laparoscopic cholecystectomy.

Biliary ductal anomalies of surgical importance can occur in 10% of patients. The short cystic duct draining into the common bile or right hepatic duct and the extreme proximity of the common bile duct in case of spiral or posterior entry of the cystic duct--if not recognized in time--can result in ductal injuries. The new mobile, digitized fluoroscopic units provide a vastly improved image within minutes. In case of an inadvertent ductal injury (extravasation, no contrast material visible in the proximal ductal system) the surgeon can immediately repair the injury. Routine intraoperative cholangiography is strongly recommended during laparoscopic cholecystectomies.