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Use an intraoperative cholangiogram to minimize BDI and find stones.

Bile duct injury (BDI) more commonly occurs following laparoscopic cholecystectomy (lap chole) than open surgery3. During lap chole, the bile ducts may be masked in some way so that the surgeon cannot see them clearly, and damage in the form of a cut, burn, or pinch may result. BDI can lead to increased morbidity and cost.

The use of an intraoperative cholangiogram (IOC) is often debated, and many surgeons see the benefits of having a map of the biliary system to confirm assumptions made during operative dissection. Cholangiography may not prevent bile duct injury, but it can help identify an impending injury before it gets too serious.1

The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), suggests surgeons employ “liberal use of cholangiography or other methods to image the biliary tree intraoperatively.”2

An IOC could also be used to identify stones in the bile duct at the time of a lap chole. Once those stones have been identified, you could perform CBD exploration to remove them or place an endobiliary stent.

Cook offers cholangiogram catheters and sets for laparoscopic cholecystectomy and for percutaneous approaches.


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    1. Olsen D. Bile duct injuries during laparoscopic cholecystectomy. Surg Endosc. 1997;11(2):133-138.
    2. The SAGES safe cholecystectomy program. SAGES Website. Accessed January 10, 2020.
    3. Connor S, Garden OJ. Bile duct injury in the era of laparoscopic cholecystectomy. Br J Surg. 2006;93(2):158-168.