Three-dimensional Virtual Cholangioscopy: a Reliable Tool for the Diagnosis of Common Bile Duct Stones

Overview

Journal Ann Surg

Specialty General Surgery

Date 2004 Jun 24

PMID 15213622

Citations 13

Authors

Michele Simone

Didier Mutter

Francesco Rubino

Erik Dutson

Catherine Roy

Luc Soler

Jacques Marescaux

Affiliations

Soon will be listed here.

Abstract

Objective: Our goal was to evaluate the clinical reliability of a new software system employing 3-dimensional (3D) virtual anatomic reconstruction and intraluminal virtual exploration for detection of choledocholithiasis and preoperative visualization of the biliary anatomy.

Summary Background Data: Virtual reality systems have been proposed for gastroscopy, bronchoscopy, and colonoscopy, as well as for the 3D reconstruction of liver anatomy and hepatic lesions. The impact of these systems in preoperative diagnostics has not been established due to the lack of large clinical series evaluating their reliability.

Methods: From November 2000 to July 2002, all patients presenting to our Institute with suspected choledocholithiasis were prospectively included in the study. All patients underwent conventional magnetic resonance cholangiopancreatography (MRCP) and either intraoperative cholangiogram (IOC) or endoscopic retrograde cholangiopancreatography (ERCP). The digital data from MRCP were incorporated into an original virtual reality software system to generate a 3D reconstruction. All 3D reconstructions were evaluated by a surgeon and a computer software engineer who were blind to the results of the IOC or ERCP. Sensitivity and specificity were then calculated based on the results of either the IOC or ERCP.

Results: Sixty-five patients were enrolled in the study. The average time required to reconstruct the images into navigable virtual reality was 7.5 minutes (range, 4-13.5). The 3D virtual cholangioscopy had sensitivity and specificity rates of 71% and 91%, respectively, compared with 61% and 86% of the standard MRCP.

Conclusion: : The 3D virtual cholangioscopy provides detailed preoperative reconstruction of biliary anatomy and reliable identification of choledocholithiasis with acceptable sensitivity and specificity in a clinical setting. Newer software developments may further enhance its accuracy, so that virtual cholangioscopy might challenge or replace more invasive diagnostic measures in the near future.

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References

Demartines N, Mutter D, Vix M, Leroy J, Glatz D, Rosel F . Assessment of telemedicine in surgical education and patient care. Ann Surg. 2000; 231(2):282-91. PMC: 1420998. DOI: 10.1097/00000658-200002000-00019. View

Falcone Jr R, Fegelman E, Nussbaum M, Brown D, Bebbe T, Merhar G . A prospective comparison of laparoscopic ultrasound vs intraoperative cholangiogram during laparoscopic cholecystectomy. Surg Endosc. 1999; 13(8):784-8. DOI: 10.1007/s004649901099. View

Yamakawa T, Sakai S, Mu Z, Pineres G . Laparoscopic management of common bile duct stones. J Hepatobiliary Pancreat Surg. 2000; 7(1):9-14. DOI: 10.1007/s005340050147. View

Boytchev I, Pelletier G, Prat F, Choury A, Fritsch J, Buffet C . [Late biliary complications after endoscopic sphincterotomy for common bile duct stones in patients older than 65 years of age with gallbladder in situ]. Gastroenterol Clin Biol. 2001; 24(11):995-1000. View

Millat B, Borie F . [Common bile duct stones and their complications]. Rev Prat. 2001; 50(19):2123-9. View

Hugier M . Prospective analysis of a scoring system to predict choledocholithiasis (Br J Surg 2000; 87: 1176-81). Br J Surg. 2001; 88(2):314-5. DOI: 10.1046/j.1365-2168.2001.01729-5.x. View

Laokpessi A, Bouillet P, Sautereau D, Cessot F, Desport J, Le Sidaner A . Value of magnetic resonance cholangiography in the preoperative diagnosis of common bile duct stones. Am J Gastroenterol. 2001; 96(8):2354-9. DOI: 10.1111/j.1572-0241.2001.04045.x. View

Scheiman J, Carlos R, Barnett J, Elta G, Nostrant T, Chey W . Can endoscopic ultrasound or magnetic resonance cholangiopancreatography replace ERCP in patients with suspected biliary disease? A prospective trial and cost analysis. Am J Gastroenterol. 2001; 96(10):2900-4. DOI: 10.1111/j.1572-0241.2001.04245.x. View

Gallagher A, Richie K, McClure N, McGuigan J . Objective psychomotor skills assessment of experienced, junior, and novice laparoscopists with virtual reality. World J Surg. 2002; 25(11):1478-83. DOI: 10.1007/s00268-001-0133-1. View

10.

Soler L, Delingette H, Malandain G, Montagnat J, Ayache N, Koehl C . Fully automatic anatomical, pathological, and functional segmentation from CT scans for hepatic surgery. Comput Aided Surg. 2001; 6(3):131-42. DOI: 10.1002/igs.1016. View

11.

Sodickson D, McKenzie C, Ohliger M, Yeh E, Price M . Recent advances in image reconstruction, coil sensitivity calibration, and coil array design for SMASH and generalized parallel MRI. MAGMA. 2002; 13(3):158-63. DOI: 10.1007/BF02678591. View

12.

Hess R, Liu C, Wang Y . Luminance spatial scale and local stereo-sensitivity. Vision Res. 2002; 42(3):331-42. DOI: 10.1016/s0042-6989(01)00285-1. View

13.

Rubino F, Soler L, Marescaux J, Maisonneuve H . Advances in virtual reality are wide ranging. BMJ. 2002; 324(7337):612. PMC: 1122526. DOI: 10.1136/bmj.324.7337.612. View

14.

Pelletier G . [Gallstones and their complications]. Rev Prat. 2002; 52(4):427-33. View

15.

Kim T, Kim B, Kim J, Ha H, Kim P, Kim A . Diagnosis of intrahepatic stones: superiority of MR cholangiopancreatography over endoscopic retrograde cholangiopancreatography. AJR Am J Roentgenol. 2002; 179(2):429-34. DOI: 10.2214/ajr.179.2.1790429. View

16.

Hugh T . New strategies to prevent laparoscopic bile duct injury--surgeons can learn from pilots. Surgery. 2002; 132(5):826-35. DOI: 10.1067/msy.2002.127681. View

17.

Cotton P, Baillie J, Pappas T, Meyers W . Laparoscopic cholecystectomy and the biliary endoscopist. Gastrointest Endosc. 1991; 37(1):94-7. DOI: 10.1016/s0016-5107(91)70637-8. View

18.

Dwyer 3rd S, Stewart B, Sayre J, Aberle D, Boechat M, Honeyman J . Performance characteristics and image fidelity of gray-scale monitors. Radiographics. 1992; 12(4):765-72. DOI: 10.1148/radiographics.12.4.1636038. View

19.

Savader S, Lillemoe K, Prescott C, Winick A, Venbrux A, Lund G . Laparoscopic cholecystectomy-related bile duct injuries: a health and financial disaster. Ann Surg. 1997; 225(3):268-73. PMC: 1190676. DOI: 10.1097/00000658-199703000-00005. View

20.

Kern K . Malpractice litigation involving laparoscopic cholecystectomy. Cost, cause, and consequences. Arch Surg. 1997; 132(4):392-7; discussion 397-8. DOI: 10.1001/archsurg.1997.01430280066009. View