Publication: Role of Intraoperative Cholangiogram in Major Liver Resection and Complex Bilio-enteric Bypass Surgery
Date
2024
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
Advances in surgery have decreased postoperative morbidities but bile leak is still a
major issue. Intraoperative cholangiogram (IOC) is considered better in identifying
bile leaks and anatomical delineation making its expanded use in hepato-biliary
surgeries.
Objective
To assess the role of intraoperative cholangiogram in major hepatectomy and
complex bilio-enteric bypass surgery.
Method
A single-centered, descriptive cross-sectional study between March 2022 to
February 2023 among conveniently sampled 32 patients undergoing Hepato-biliary
surgeries. One ampoule of meglumine diatrizoate was instilled into the biliary tract
and intraoperative pictures were taken via C-arm to visualize the biliary tree and pre-
operative and intra-operative pictures were compared.
Result
A total of 32 patients were included in the study with a median age of 42 years and a
male-female ratio of 1:1.67. During the bilio-enteric anastomosis, no intraoperative
anastomotic leaks were detected. Two patients experienced postoperative bile
leakage that was managed conservatively and eight cases had intraoperative bile
leakage which was addressed during surgery. The average duration of hospital stay
was 5 days.
Conclusion
An intraoperative cholangiogram is useful to delineate the biliary tract anatomy,
reassure anastomosis, and identify bile leaks in difficult bilio-enteric anastomosis and
from liver resection margins intraoperatively.
KEY WORDS
Complex hepatobiliary surgery, Intraoperative cholangiogram, Liver resection
Description
Ghimire R, Pandey P, Acharya BP
Department of Gastrointestinal and General Surgery
Kathmandu Medical College Teaching Hospital
Kathmandu, Nepal
Keywords
Complex hepatobiliary surgery, Intraoperative cholangiogram, Liver resection