What is a cholangiogram?

An intraoperative cholangiogram (IOC) is an X-ray of your bile ducts. It’s usually done during surgery to remove your gall bladder.

Why is it done?

Having a view of your bile duct during surgery involving your gallbladder helps your surgeon check for gallstones and avoid damaging your bile duct.

Gallstones are made of hardened substances, usually cholesterol, that have collected inside your gallbladder. In addition to causing pain and inflammation in your bile ducts, gallstones can also cause a blockage in those ducts, even if you’ve had your gallbladder removed.

How is it done?

Before having surgery, you’re likely to be given general anesthesia. Depending on the type of surgery, your doctor then makes either one large incision for traditional open surgery or several smaller cuts for laparoscopic surgery.

Next, they insert a catheter through one of these cuts and place it in your cystic duct, which connects your gallbladder to your common bile duct. Using this catheter, they’ll inject a special type of dye into the duct. This dye will allow your surgeon to view your bile ducts on a monitor while they remove your gallbladder and check for gallstones.

If the IOC shows that you do have gallstones, your surgeon may remove them during the procedure or have you schedule a follow-up appointment to treat them.

Do I need to prepare for it?

You don’t need to do anything to prepare for an IOC. However, you can prepare for gallbladder surgery by:

  • getting a physical exam to check your overall health
  • letting your doctor know about any allergies you have, especially to contrast dye
  • not eating for at least 12 hours before the surgery
  • avoiding blood thinners, aspirin, or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
  • packing some personal belongings in case you need to stay in the hospital overnight
  • arranging for a friend or family member to drive you home after surgery

Does it require any recovery?

Recovery from an IOC is usually quick and easy. However, you may need additional recovery time depending on the type of surgery you have. If your doctor uses a laparoscopic technique for surgery, you’ll likely be able to go home the same day. In some cases, you may need to stay overnight or a few days until you can eat, drink, and use the bathroom without any trouble.

If you’ve had open surgery, you may need to stay for a week or more.

To help ensure you have a smooth recovery, follow these tips:

  • Take any prescribed pain medications.
  • Allow your body plenty of time to rest by taking a few days off from work and other daily activities.
  • Make any changes to your diet that your doctor recommends. Without a gallbladder, you may need to avoid certain high-fat foods.
  • If you’re breastfeeding, wait at least 24 hours for the contrast fluid to leave your body before feeding your baby again.

Your doctor may also schedule a follow-up appointment to confirm that no gallstones are left in your bile ducts and drain any extra bile.

Are there are any risks associated with it?

IOCs aren’t associated with any risks. In fact, a recent study found that they can reduce your risk of having complications during gallbladder surgery by 62 percent.

Complications from gallbladder surgery include:

These complications are possible with any surgery, but IOC done along with gallbladder removal can lower your risk of complications.

The bottom line

Having an IOC during gallbladder surgery helps your doctor avoid damaging your bile ducts and spot any remaining gallstones you might have before completing the procedure. It carries no risks and can greatly reduce the chance of any problems during surgery.