To the Editor.—The article on "Operative Cholangiography" by Sachatello and Griffen (Arch Surg 109:454, 1974) brought to mind a few comments on the subject that may be appropriate. Most of these points have been made by others, but they still will benefit by the emphasis of repetition.
First, if operative cholangiography is to be of greatest usefulness it should be used in all cases, not in just those patients with anatomical findings suggesting choledochal disease or pancreatitis. Reliance on the usual clinical criteria for exploration of the common duct has long since been discredited as inadequate for maximal clearance of calculi from the extrahepatic biliary tree. The accuracy of this statement is attested to by the many articles on retained stones that have been published. Furthermore, when roentgenograms are obtained on an occasional basis, they will frequently suffer from technical inadequacies. Needless to say, optimum results from roentgenograms of