Intraoperative Cholangiography Use Doesn’t Lower Bile Duct Injury

Surgeons should know that increased use of intraoperative cholangiography (IOC) during cholecystectomy does not reduce bile duct injury rates, but it does lead to more postoperative ERCP procedures.

• Among 434,696 patients, BDI rates were low and similar across IOC use groups (0.5% for never, 0.4% for selective, and 0.4% for routine).
• Postoperative ERCP rates increased with IOC use: 8.1% for never users, 10.4% for selective, and 12.0% for routine users (all p<0.001).

Surgeons may need to reconsider the necessity and thresholds for IOC to optimize patient outcomes and resource use.