ArticleJournal of the American College of Surgeons2012
Variation in the use of intraoperative cholangiography during cholecystectomy.
Article in Journal of the American College of Surgeons, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 47 citations in OpenAlex.
- ERCP and laparoscopic cholecystectomy in a combined (one-step) procedure: a random comparison to the standard (two-step) procedure.Surgical endoscopy · 2013Trial
- Statewide patterns of intraoperative cholangiography utilization during inpatient and outpatient cholecystectomy in Texas.Surgical endoscopy · 2026Article
- National trends in utilization and readmission following intraoperative cholangiography in gallstone pancreatitis.Surgery open science · 2025Article
- Article
- Laparoscopic Cholecystectomy Using Indocyanine Green Fluorescence Imaging in a Patient with a Type I Accessory Hepatic Duct (Hisatsugu Classification): A Case Report.Surgical case reports · 2025Article
- A Systematic Review of Laparoscopic Ultrasonography During Laparoscopic Cholecystectomy.Cureus · 2023Review
- A meta-analysis of the use of intraoperative cholangiography; time to revisit our approach to cholecystectomy?Surgery open science · 2021Review
- A new fluorescence imaging technique for visualizing hepatobiliary structures using sodium fluorescein: result of a preclinical study in a rat model.Surgical endoscopy · 2018Article
- Laparoscopic cholecystectomy with aberrant bile duct detected by intraoperative fluorescent cholangiography concomitant with angiography: A case report.International journal of surgery case reports · 2018Article
- Laparoscopic ultrasonography as an alternative to intraoperative cholangiography during laparoscopic cholecystectomy.World journal of gastroenterology · 2017Review
- Impact of intraoperative cholangiography on postoperative morbidity and readmission: analysis of the NSQIP database.Surgical endoscopy · 2016Observational
- Routine ultrasound and blood tests after laparoscopic cholecystectomy-are they worthwhile? A diagnostic accuracy study.Langenbeck's archives of surgery · 2016Article
- Scoring System for the Management of Acute Gallstone Pancreatitis: Cost Analysis of a Prospective Study.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2016Article
- Timing and nature of presentation of unsuspected retained common bile duct stones after laparoscopic cholecystectomy: a retrospective study.Surgical endoscopy · 2015Article
- Routine use of fluorescent incisionless cholangiography as a new imaging modality during laparoscopic cholecystectomy.Surgical endoscopy · 2015Article
- Techniques of Fluorescence Cholangiography During Laparoscopic Cholecystectomy for Better Delineation of the Bile Duct Anatomy.Medicine · 2015Observational
- Cost analysis and effectiveness comparing the routine use of intraoperative fluorescent cholangiography with fluoroscopic cholangiogram in patients undergoing laparoscopic cholecystectomy.Surgical endoscopy · 2014Article
- Article
- Laparoscopic cholecystectomy: first, do no harm; second, take care of bile duct stones.Surgical endoscopy · 2013Article
- The impact of intraoperative cholangiography on recurrent pancreatitis and biliary complications in patients with gallstone pancreatitis.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2012Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThe role of intraoperative cholangiography (IOC) in prevention of common bile duct (CBD) injuries and the management of CBD stones is controversial, and current variation in use of IOC has not been well described. STUDY
designMultilevel hierarchical models using data from the Texas Hospital Inpatient Discharge Public Use data files (2001 to 2008) were used to evaluate the percentage of variance in the use of IOC that was attributable to patient, surgeon, and hospital factors.
resultsA total of 176,981 cholecystectomies were performed in 212 hospitals in Texas. There was wide variation in IOC use, ranging from 2.4% to 98.4% of cases among surgeons and 3.7% to 94.8% of cases among hospitals, even after adjusting for case mix differences. The percentage of variance in IOC use attributable to the surgeon was 20.7% and an additional 25.7% was attributable to the hospital. IOC use was associated with increased age, gallstone pancreatitis or CBD stones, Hispanic race, decreased illness severity, insurance, and later year of cholecystectomy. ERCP (24.0% vs 14.9%, p < 0.0001) and CBD exploration (1.63% vs 0.42%, p < 0.0001) were more commonly performed in patients undergoing IOC.
conclusionsUncertainty regarding the benefit of IOC leads to wide variation in use across surgeons and hospitals. The surgeon and hospital are more important determinants of IOC use than measured patient characteristics. Our study highlights the need for further evaluation of comparative effectiveness of IOC in the prevention of CBD injuries and retained stones, taking into account patient risk factors, surgeon skill, cost, and availability of local expertise.
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