N-OTC is associated with shorter operative time and fewer peri-operative complications , and it is comparable to R-OTC in terms of CBD injury risk during cholecystectomy .
R-OTC is helpful for peri-operative CBD stone detection and there is therefore reduced readmission for retained CBD stones .
The N-OTC approach may be adopted routinely for patients undergoing laparoscopic cholecystectomy providing there are no clinical , biochemical or radiological features suggestive of CBD stones .
INTRODUCTION The aim of this review was to systemically analyse trials evaluating the efficacy of routine on-table cholangiography ( R-OTC ) versus no on-table cholangiography ( N-OTC ) in patients undergoing cholecystectomy .
[Intraoperative cholangiography as a routine method? A prospective, controlled, randomized study].
A prospect i ve , controlled , r and omized trial was conducted in 275 patients with symptomatic gall stone disease , whose history , laboratory data or sonographical findings did not suggest common bile duct stones . Of these patients , 137 did not undergo intraoperative fluoroscopic cholangiography ( IOC ) , but in the remaining 138 patients IOC was attempted . In 111 cases ( 80.4 % ) the biliary system was sufficiently visualized . In 3 patients ( 2.7 % ) calculi in the cystic or common bile duct were diagnosed , which would have been overlooked without IOC . IOC was false-positive in one case . One year after the operation the patients were asked to return for a follow-up examination . Three patients in the group without IOC had had symptomatic passage of a stone , and one had a common bile duct stone removed by endoscopic papillotomy . A retained stone was discussed as etiology for a pancreatitis in a fifth patient in this group . No patient sustained long-term sequelae from the retained common bile duct stones . None of the patients in the IOC group had evidence of cholangiolithiasis at follow-up . There was no difference between the study groups concerning the incidence of post-operative complications . The operations with IOC  lasted significantly longer ( 92 + /- 31 min vs 77 + /- 28 min ) . According to our data and those published earlier , the additional financial and logistic expenditure associated with routine IOC is not justified . Patients with the preoperative suspicion of a common bile duct stone should have endoscopic bile duct clearance ( ERCP and EPT ) prior to cholecystectomy
N-OTC is associated with shorter operative time and fewer peri-operative complications , and it is comparable to R-OTC in terms of CBD injury risk during cholecystectomy .
R-OTC is helpful for peri-operative CBD stone detection and there is therefore reduced readmission for retained CBD stones .
The N-OTC approach may be adopted routinely for patients undergoing laparoscopic cholecystectomy providing there are no clinical , biochemical or radiological features suggestive of CBD stones .
INTRODUCTION The aim of this review was to systemically analyse trials evaluating the efficacy of routine on-table cholangiography ( R-OTC ) versus no on-table cholangiography ( N-OTC ) in patients undergoing cholecystectomy .