Evaluation of Intraoperative Findings and the Role of Biliary Mapping Using Methylene Blue in Laparoscopic Cholecystectomy: A Cross-sectional Study.

Background: Laparoscopic cholecystectomy (LC) is the most effective treatment for gallstones. Anomalies in the biliary tree provide a risk and increase the probability of bile duct injury. The use of methylene blue for bile duct mapping may enhance intraoperative visibility; nevertheless, its efficacy and feasibility remain uncertain.

Aim: The aim of this study was to evaluate intraoperative findings during LC and assess the role of biliary mapping using methylene blue in identifying biliary anatomy and reducing complications.

Materials and methods: A total of 84 gallstone patients scheduled for LC were included. After obtaining informed consent from the patients, methylene blue was injected into the gallbladder to visualize the architecture of the bile ducts. The intraoperative results, anatomical changes, and complications were analyzed.

Results: The majority of intraoperative findings consisted of short cystic ducts (55.95%), followed by normal ducts (13.10%) and elongated ducts (8.33%). Uncommon observations included intrahepatic gallbladder (4.76%), colonic adherent gallbladder (2.38%), and twisted common bile duct. No significant adverse effects of methylene blue were noted. Methylene blue bile mapping enhanced the visibility of the bile duct architecture, particularly in cases with anatomical anomalies, and reduced the likelihood of bile duct injury.

Conclusion: Methylene blue bile mapping is a cost-effective and practical tool for LC that identifies bile duct architecture and reduces problems. This study suggests that it may be safer than intraoperative cholangiography in resource-limited situations.