Reliability of Conventional Indications for Common Bile Duct Exploration

This study was made to test the validity of our clinical indications for common bile duct exploration by examining the results in our personal series of biliary procedures done over a period of 23 years. In this period we have not routinely employed operative cholangiography but cholangiograms have always been taken in the postoperative period prior to the removal of any T-tube. Only during the past five years have we employed table cholangiography prior to abdominal closure whenever the common duct has been explored on our clinical indications, but this examination has not been used until very recently to determine the necessity for common duct exploration. It was our primary purpose to see whether these criteria were reliable.

The criteria which we employ for making the decision to explore the common duct are: (a) a definite history of jaundice or existing jaundice, (b) multiple small stones in the gallbladder, (c)