Outcomes of Laparoscopic Cholecystectomy Using a Preoperative Imaging Protocol Based on Ultrasound and MRCP: A Retrospective Study from a Non-Intraoperative Cholangiography Center

Background: Laparoscopic cholecystectomy (LC) is the standard treatment for symptomatic gallstone disease. However, in centers without intraoperative cholangiography (IOC), the risk of bile duct injury and missed choledocholithiasis remains a concern. This study evaluated the outcomes of LC using a preoperative imaging protocol involving ultrasound (USG) and magnetic resonance cholangiopancreatography (MRCP). Methods: A retrospective analysis was conducted on 50 patients who underwent elective LC over one year at a tertiary care center without IOC facility. All patients underwent USG, and those with suspected common bile duct (CBD) stones or anatomical variants were further evaluated with MRCP. Intraoperative findings, surgical outcomes, postoperative complications, and readmissions were recorded and analyzed. Results: Of the 50 patients, 32 were female (64%) and 18 were male (36%), with a mean age of 42.6 years. MRCP was performed in 20 patients (40%), confirming CBD stones in 5 (10%) and anatomical anomalies in 3 (6%). LC was uneventful in 90% of cases; 2 patients (4%) required conversion to open surgery. There were no bile duct injuries. Postoperative complications occurred in 3 patients (6%), with one readmission. Conclusion: A preoperative imaging protocol combining USG and MRCP provides a safe and effective alternative to IOC in laparoscopic cholecystectomy.