An operative cholangiogram is an imaging study used during gallbladder surgery to reveal the outline of the bile duct and detect blockages or injuries. Bile duct injury is a known complication of laparoscopic surgery. Contrast agents are used to highlight the bile duct during the procedure. Other cholangiography methods include percutaneous transhepatic cholangiography (PTC).
An operative cholangiogram is a type of imaging study done during gallbladder surgery. The cholangiogram uses an x-ray opaque dye to reveal the outline of the bile duct, the tube that drains bile juices from the gallbladder. This is useful because it shows if the bile duct is blocked by a gallstone, allowing the surgeon to remove the stone during the operation. An operative cholangiogram can also help reveal any injuries to the bile duct that may occur during surgery. Bile duct injury is a known complication of gallbladder surgery when keyhole or laparoscopic techniques are used.
Bile is digestive juice that is produced in the liver and stored inside the gallbladder. When a person eats, bile is released from the gallbladder and passes through the bile duct into the intestines where it helps digest fatty foods. Sometimes the bile inside the gallbladder crystallizes into stones, which can block its exit. This can cause a condition known as cholecystitis, in which the gallbladder becomes swollen and inflamed. Stones can leak from the gallbladder and lodge in the bile duct causing symptoms such as pain and jaundice, in which case surgery to remove the gallbladder and stones may be needed.
The process by which an operative cholangiogram is performed is called a cholangiography. Laparoscopic instruments, which are inserted into the abdomen through small skin incisions, are used to perform gallbladder surgery and to perform cholangiograms. A special dye, known as a contrast agent, is injected into the bile duct and X-ray images are taken which the surgeon can view on a monitor. Because contrast medium does not pass X-rays, areas where it is present appear highlighted on x-ray images. This means that the operative cholangiogram will clearly show if the bile duct is blocked by a stone or calculi and should also reveal any accidental damage caused by the surgery.
In addition to an operative cholangiogram, there are other cholangiography methods that can be used to examine the bile duct. What’s called percutaneous transhepatic cholangiography (PTC) involves injecting contrast medium through the skin into that area of the liver that drains into the bile duct. This procedure can be done while the patient is awake and can be used to decide what further treatment is needed.
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