Intraoperative Ultrasonography (IOUS) During Laparoscopic Cholecystectomy

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 1996 Jun 1

PMID 8662399

Citations 8

Authors

R Santambrogio

P Bianchi

E Opocher

A Mantovani

L Schubert

F Ghelma

M Panzera

M Verga

G P Spina

Affiliations

Soon will be listed here.

Abstract

Background: The purpose of this study was to evaluate the usefulness of intraoperative ultrasonography (IOUS), a new method of imaging the biliary tree and related structures, during laparoscopic cholecystectomy.

Method: An IOUS probe (Aloka, Tokyo, Japan) with a 7.5-MHz linear-array transducer was used during cholecystectomy in 124 patients with symptomatic cholelithiasis (45 men, 79 women; mean age, 48 +/- 14 years).

Results: The examination of the common bile duct (CBD) was excellent in 117 patients but unsatisfactory in 7 cases (5.6%) at the level of the head of the pancreas. In 5 patients, IOUS showed unsuspected choledocholithiasis: a subsequent intraoperational cholangiogram confirmed this. In five cases IOUS was able to help the surgeon to localize a Calot area obscured by inflammation. Postoperatively, one patient had an injury of the cystic duct stump: a nasobiliary tube resolved the bile leakage after 7 days. Another patient was submitted to postoperative endoscopic retrograde cholangiopancreatography (ERCP) for a choledocholithiasis recognized by a trans-cystic-tube cholangiography: the stone was suspected but not demonstrated either by laparoscopic IOUS or by intraoperative cholangiography. During the follow-up period, one patient had an episode of acute pancreatitis. ERCP showed a small stone wedged in the sphincter of Oddi.

Conclusions: IOUS may be a real alternative to cholangiography during laparoscopic cholecystectomy since it is safer and offers a complete examination of the biliary tree. It has some disadvantages which can solved by additional experience.

Citing Articles

Ultrasound for intraoperative localization of lung nodules during thoracoscopic surgery.

Huang Y, Chen K, Chen J Ann Transl Med. 2019; 7(2):37.

PMID: 30854390 PMC: 6381266. DOI: 10.21037/atm.2019.01.41.

Laparoscopic ultrasonography as an alternative to intraoperative cholangiography during laparoscopic cholecystectomy.

Dili A, Bertrand C World J Gastroenterol. 2017; 23(29):5438-5450.

PMID: 28839445 PMC: 5550794. DOI: 10.3748/wjg.v23.i29.5438.

Safe laparoscopic clearance of the common bile duct in emergently admitted patients with choledocholithiasis and cholangitis.

Atstupens K, Plaudis H, Fokins V, Mukans M, Pupelis G Korean J Hepatobiliary Pancreat Surg. 2016; 20(2):53-60.

PMID: 27212991 PMC: 4874043. DOI: 10.14701/kjhbps.2016.20.2.53.

Meta-analysis of the diagnostic accuracy of laparoscopic ultrasonography and intraoperative cholangiography in detection of common bile duct stones.

Jamal K, Smith H, Ratnasingham K, Siddiqui M, McLACHLAN G, Belgaumkar A Ann R Coll Surg Engl. 2016; 98(4):244-9.

PMID: 26985813 PMC: 5226022. DOI: 10.1308/rcsann.2016.0068.

Prevention and treatment of bile duct injuries during laparoscopic cholecystectomy: the clinical practice guidelines of the European Association for Endoscopic Surgery (EAES).

Eikermann M, Siegel R, Broeders I, Dziri C, Fingerhut A, Gutt C Surg Endosc. 2012; 26(11):3003-39.

PMID: 23052493 DOI: 10.1007/s00464-012-2511-1.

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