When should an intraoperative cholangiogram be performed?
- Selective versus routine IOC remains controversial.
- A critical review of the literature demonstrates that routine IOC trends toward a decrease in the incidence of bile duct injury, but does not reach statistical significance.
- IOC may also identify unsuspected common bile duct stones that can then be removed via laparoscopic common bile duct exploration.
- An IOC does add time to the procedure, however, and surgeons often defer an IOC if the critical view of safety is achieved. SAGES recommends routine IOC
