Implications of routine cholangiography during laparoscopic cholecystectomy on postoperative testing: Review of more than 2,300 cases in a community-based practice - 29/08/23
, William S. Harmsen d, Talya A. Lorenz a, Robert C. Wendt e, Mokhshan Ramachandran b, Shelby A. Stewart c, Hayden J. Swartz c, Maria E. Linnaus aAbstract |
Background |
We hypothesized that routine cholangiography during laparoscopic cholecystectomy may increase use of postoperative imaging and invasive testing.
Methods |
A retrospective review was performed of laparoscopic cholecystectomy cases at 6 community hospitals from 2017 through 2020. For surgeons performing routine vs selective cholangiography, we compared primary outcomes of operative time, 30-day complications, and postoperative imaging or procedures.
Results |
In total, 2359 laparoscopic cholecystectomy procedures were performed. Eighteen surgeons performed routine cholangiography (1125 cases), and 13 performed selective (1234 cases). Mean operative time was longer in the routine group (125.3 vs 98.7 min, P < .001). Between groups, 30-day complications were similar. Two common bile duct injuries were identified in the routine group. Postoperatively, the routine group underwent 2.5 times more imaging and invasive testing (P < .001).
Conclusions |
In community hospitals, laparoscopic cholecystectomy can be performed safely by surgeons using cholangiography routinely or selectively. Routine cholangiography resulted in more postoperative imaging and invasive testing.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Routine and selective cholangiography during laparoscopic cholecystectomy are safe. |
• | Operative times were longer with routine cholangiography. |
• | Patients having routine cholangiography underwent more imaging and invasive tests. |
Keywords : Acute cholecystitis, Bile duct, Common bile duct obstruction, Gallbladder, Laparoscopy
Abbreviations : CBD, IOC, ERCP, EUS, MRCP
Plan
| ☆ | Reprints: Jason Beckermann, MD, Department of Surgery, Mayo Clinic Health System — Northwest Wisconsin Region, 1400 Bellinger St, Eau Claire, WI 54703 beckermann.jason@mayo.edu Phone: 715-838-6140 Fax 715-838-6613) |
Vol 226 - N° 2
P. 251-255 - août 2023 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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