Operative cholangiography in uncomplicated biliary tract surgery. Review of 354 cholangiography studies in patients without indication of common duct pathology.

The literature of the past ten years is replete with articles on "routine* cholangiography, with particular reference to the overlooked or "unsuspected" stone. Many series do not differentiate between T-tube cholangiograms performed after common duct exploration and those performed on patients with and without the usual clinical or operative indications for common duct exploration. We present a pure operative cholangiographic study of 354 patients with apparent uncomplicated bilary tract disease; a significant incidence of unsuspected pathologic features are demonstrated. Can a convenient and innocuous procedure like routine operative cholangiography continue to be ignored, even in the most routine of cases?