Indications and accuracy of operative cholangiography.

We have demonstrated that operative cholangiography can be done accurately, rapidly, and without any increase in morbidity. We recommend that operative cholangiography be performed routinely on all patients undergoing cholecystectomy for these reasons: (1) It permits accurate demonstration of the presence or absence of intraductal calculi, thereby decreasing the number of unnecessary duct explorations. (2) It permits demonstration of the number and size of common duct stones, when their presence is highly suspected. (3) It permits recognition of a small but substantial number of patients with unsuspected common duct stones. (4) It permits demonstration of operative ductal anatomy, thereby reducing the chance of inadvertent iatrogenic injury. (5)It permits recognition of unsuspected biliary or periampullary tumors. (6) It is an accurate method and facilitates the performance and accurate interpretation of postoperative T-tube cholangiography.