The major role of the operative cholangiogram within the indications for common bile duct exploration.

The accuracy of the clinical indications for common bile duct exploration was studied in a group of 495 patients. The patients were divided into two groups: operative cholangiography was performed in 5 per cent of cases in Group A and 62 per cent of cases in Group B. The results demonstrate the high efficiency of this procedure, its safety, accuracy (82%), and its effectiveness in the discovery of unexpected stones and in shortening of hospitalization. Analysis of the results point out the indications for intraoperative cholangiography: It should be carried out in all biliary tract operations, except for those in which other clinical indications for exploration already exist (palpable stones in the common bile duct or the combination of dilated common bile duct either with jaundice at the time of operation or with history of severe jaundice in the past). Under all other circumstances an operative cholangiogram should be performed.