Thesis (M.Sc.) - Cairo University - Faculty Of Medicine - Department Of General Surgery

Numerous techniques for cholangiography during laparoscopic cholecystectomy have been described ; almost all of which require cannulation of the cystic ductFor the infrequent user , it can be time consuming and difficult procedureThe wide variety of techniques , catheters and forceps used to aid cannulation testify to this difficulty10 patients with symptomatizing gallbladder stones were studied in this series5 of them were evaluated for cholecysto - cholangiography and the other 5 for transcystic - cholangiographyThe success rate in cholecysto - cholangiography approached 80 with excellent quality films obtainedDelineation of anatomy approached 85 ; 75for transcystic cholangiography ; and exposure time to radiation compares favourably with cystic duct cannulation with a mean time 24minsCholecysto - cholangiography added less than 11mins to the procedure ; mean 104mins , while transcystic cholangiography added an extra 30mins ; mean 31minsThere were no cholangiogram related complications or false positive findings in our series with a smooth follow up period for one monthOur early experience with the procedure of cholecysto - cholangiography , and based upon the results of our study we conclude that laparoscopic cholecysto - cholangiography is a safe , simple , quick and inexpensive method of intraoperative cholangiography that can be used as an alternative to cystic duct cholangiography ; with virtually no 'learning curve'' ; to identify biliary anatomy prior to laparoscopic dissection whereby possible iatrogenic injury to the hepatic or common bile duct can be avoidedThe acceptance of this procedure may encourage surgeons to perform cholangiography during laparoscopic cholecystectomy

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