{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T12:46:54Z","timestamp":1778762814256,"version":"3.51.4"},"reference-count":29,"publisher":"Wiley","issue":"1-2","license":[{"start":{"date-parts":[[2022,12,22]],"date-time":"2022-12-22T00:00:00Z","timestamp":1671667200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The incidence of choledocholithiasis on routine intraoperative cholangiogram (IOC) during cholecystectomy is approximately 12%. Cholecystectomy without IOC may lead to undiagnosed choledocholithiasis placing patients at risk of complications such as pancreatitis or cholangitis. This study aims to determine\u00a0the incidence of choledocholithiasis intraoperatively as well as the associated risk factors and the methods of management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective observational analysis of all laparoscopic cholecystectomies with IOC at the Gold Coast Hospital and Health Service from 1 January 2016 to 2 December 2021 was carried out. Patient demographics, operative data and cholangiogram findings were collected from electronic medical systems.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 3904 cholecystectomies were carried out over the study period. 3520 (90.1%) had an IOC, and 474 (13.4%) had positive IOC findings. 158 (33.3%) of the cases were managed intraoperatively with hyoscine butylbromide with or without intravenous glucagon followed by biliary tree flushing alone, 183 (38.6%) received transcystic bile duct exploration (TCBDE) with a success rate of 83% and 167 (35.2%) received endoscopic retrograde cholangiopancreatography (ERCP). Choledocholithiasis was incidental in 44 (9.28%) patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Incidental choledocholithiasis during routine IOC is not uncommon. Management predominantly includes intraoperative TCBDE or postoperatively via an ERCP. This study has not found reliable preoperative factors to predict choledocholithiasis based on preoperative clinical, radiological and biochemical factors. A small proportion of patients received preoperative endoscopic intervention, and the decision\u2010making process requires further investigation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.18215","type":"journal-article","created":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T07:35:50Z","timestamp":1671780950000},"page":"139-144","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Incidence and management of choledocholithiasis on routine intraoperative cholangiogram: a 5\u2010year tertiary centre experience"],"prefix":"10.1111","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4730-1877","authenticated-orcid":false,"given":"Justin","family":"Ng","sequence":"first","affiliation":[{"name":"Department of General Surgery Gold Coast University Hospital\u2014Gold Coast Hospital and Health Service  Gold Coast Queensland Australia"},{"name":"Faculty of Health Sciences and Medicine Bond University  Gold Coast Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roy","family":"Teng","sequence":"additional","affiliation":[{"name":"Department of General Surgery Gold Coast University Hospital\u2014Gold Coast Hospital and Health Service  Gold Coast Queensland Australia"},{"name":"School of Medicine and Dentistry Griffith University  Gold Coast Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8289-130X","authenticated-orcid":false,"given":"Sara","family":"Izwan","sequence":"additional","affiliation":[{"name":"Department of General Surgery Gold Coast University Hospital\u2014Gold Coast Hospital and Health Service  Gold Coast Queensland Australia"},{"name":"School of Medicine and Dentistry Griffith University  Gold Coast Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0993-5294","authenticated-orcid":false,"given":"Erick","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of General Surgery Gold Coast University Hospital\u2014Gold Coast Hospital and Health Service  Gold Coast Queensland Australia"},{"name":"School of Medicine and Dentistry Griffith University  Gold Coast Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maarisha","family":"Kumar","sequence":"additional","affiliation":[{"name":"School of Medicine and Dentistry Griffith University  Gold Coast Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramesh","family":"Damodaran Prabha","sequence":"additional","affiliation":[{"name":"Department of General Surgery Gold Coast University Hospital\u2014Gold Coast Hospital and Health Service  Gold Coast Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harald","family":"Puhalla","sequence":"additional","affiliation":[{"name":"Department of General Surgery Gold Coast University Hospital\u2014Gold Coast Hospital and Health Service  Gold Coast Queensland Australia"},{"name":"Faculty of Health Sciences and Medicine Bond University  Gold Coast Queensland Australia"},{"name":"School of Medicine and Dentistry Griffith University  Gold Coast Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,12,22]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"247","article-title":"Choledocholithiasis in acute calculous cholecystitis: guidelines and beyond","volume":"34","author":"Reddy S","year":"2021","journal-title":"Ann. 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