A Prospective, Blinded Comparison of Laparoscopic Ultrasound with Transabdominal Ultrasound for the Detection of Gallbladder Pathology in Morbidly Obese Patients

Kothari, Shanu N.; Obinwanne, Kosisochi M.; Baker, Matthew T.; Mathiason, Michelle A.; Kallies, Kara J.

doi:10.1016/j.jamcollsurg.2013.02.009

Cited by 13 publications

(7 citation statements)

References 25 publications

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“…In the series published after 2000 (Table 6 ), Hublet et al[ 12 ], in a prospective non randomized study, reported the diagnosis of one case with hemobilia (which could have been interpreted as a filling defect in IOC imaging), 1 pancreatic pseudocyst, 1 case of IPMN, 1 pancreas divisum, and 1 patient with micro-calcifications of the head of the pancreas. Other authors report the identification of gallbladder polyps[ 74 ], Mirizzi syndrome[ 50 ], lobar atrophy/hypertrophy, or rotational anomalies of the liver[ 54 ]. In a prospective non randomized study published in 2007, Machi et al[ 51 ] diagnosed cystic or solid tumors of the liver or pancreas during systematic examination via LUS.…”

Section: Resultsmentioning

confidence: 99%

Laparoscopic ultrasonography as an alternative to intraoperative cholangiography during laparoscopic cholecystectomy

Dili

Bertrand

2017

WJG

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AIMTo assess the role of laparoscopic ultrasound (LUS) as a substitute for intraoperative cholangiography (IOC) during cholecystectomy.METHODSWe present a MEDLINE and PubMed literature search, having used the key-words “laparoscopic intraoperative ultrasound” and “laparoscopic cholecystectomy”. All relevant English language publications from 2000 to 2016 were identified, with data extracted for the role of LUS in the anatomical delineation of the biliary tract, detection of common bile duct stones (CBDS), prevention or early detection of biliary duct injury (BDI), and incidental findings during laparoscopic cholecystectomy. Data for the role of LUS vs IOC in complex situations (i.e., inflammatory disease/fibrosis) were specifically analyzed.RESULTSWe report data from eighteen reports, 13 prospective non-randomized trials, 5 retrospective trials, and two meta-analyses assessing diagnostic accuracy, with one analysis also assessing costs, duration of the examination, and anatomical mapping. Overall, LUS was shown to provide highly sensitive mapping of the extra-pancreatic biliary anatomy in 92%-100% of patients, with more difficulty encountered in delineation of the intra-pancreatic segment of the biliary tract (73.8%-98%). Identification of vascular and biliary variations has been documented in two studies. Although inflammatory disease hampered accuracy, LUS was still advantageous vs IOC in patients with obscured anatomy. LUS can be performed before any dissection and repeated at will to guide the surgeon especially when hilar mapping is difficult due to fibrosis and inflammation. In two studies LUS prevented conversion in 91% of patients with difficult scenarios. Considering CBDS detection, LUS sensitivity and specificity were 76%-100% and 96.2%-100%, respectively. LUS allowed the diagnosis/treatment of incidental findings of adjacent organs. No valuable data for BDI prevention or detection could be retrieved, even if no BDI was documented in the reports analyzed. Literature analysis proved LUS as a safe, quick, non-irradiating, cost-effective technique, which is comparatively well known although largely under-utilized, probably due to the perception of a difficult learning curve.CONCLUSIONWe highlight the advantages and limitations of laparoscopic ultrasound during cholecystectomy, and underline its value in difficult scenarios when the anatomy is obscured.

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Section: Resultsmentioning

confidence: 99%

Laparoscopic ultrasonography as an alternative to intraoperative cholangiography during laparoscopic cholecystectomy

Dili

Bertrand

2017

WJG

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“…The classic appearance of CBDS is a rounded echogenic lesion with posterior acoustic shadowing [47]. Although TAUS is considered the gold standard for detecting cholelithiasis [48] having a sensitivity of approximately 99% and a specificity of 99% for detection of GB stone [49], but sensitivity of TAUS in diagnosis CBDS varies from 20% to 80% depending on the operator [27] [38], due to the following causes: 1) Some time no fluid rim will be seen around an impacted distal CBDS because it is compressed against the duct wall. The lateral margins of the stone are therefore not seen, decreasing the conspicuity of the stone, versus a stone seen in the gallbladder or proximal duct, where it is likely to be surrounded by bile [38] (Figure 3 bright, linear echogenicity, either straight or curved.…”

Section: Transabdominal Ultrasound (Taus)mentioning

confidence: 99%

The Accuracy of Transabdominal Ultrasound in Detection of the Common Bile Duct Stone as Compared to Endoscopic Retrograde Cholangiopancreatography (with Literature Review)

Alkarboly¹,

Fatih²,

Hussein³

et al. 2016

OJGas

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Introduction: Common bile duct stone (CBDS) is a common clinical problem that can cause serious complications, such as acute cholangitis and pancreatitis. It is important to have an accurate, safe, and reliable method for the definitive diagnosis of CBDS before proceeding to therapeutic endoscopic retrograde cholangiopancreatography (ERCP). Objective: To compare the accuracy of trans-abdominal ultrasound (TAUS) as a diagnostic tool at our institution-Kurdistan Centre for Gastroenterology & Hepatology (KCGH)-with invasive tool like ERCP in the diagnosis of bile duct stones, using specificity, sensitivity, and positive and negative predictive values. Patient and Method: After obtaining ethical committee approval & informed consent from every patient. This was a prospective study conducted on 71 patients (24 male patients and 47 females patients) where suspected to have CBDS depending on history, clinical suspicion and blood tests. Their ages range between (2-88 years). Both TAUS and ERCP were performed. Final diagnosis was confirmed depending on ERCP as it served as a diagnostic standard in diagnosing CBDS. Result: In 71 patients suspected to have CBDS by TAUS, only 46 patients had stone (65%), and 55 patients had stone by ERCP (77%). In our result, sensitivity, specificity, positive predictive value and negative predictive value for TAUS were 80%, 87.5%, 65.5% and 56%, respectively. Conclusion: TAUS can play an important role as an initial screening procedure for CBDS detection because of the various advantages like easy availability, cost effectiveness, no requirement of contrast material and lack of ionizing radiation but should done with other imaging modality to avoid serious complication of ERCP.

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“…Most patients with GSD are asymptomatic, and approximately 20% become symptomatic after 10 years of follow-up [2] . Ultrasonography is recognized as the gold standard for diagnosing GSD [3] .Ultrasonography-based studies showed that the cumulative incidence rate of GSD is 0.67% per year (0.66% in males, 0.81% in females) in Italians and the incidence rate is 1.39 per 100 person-years in Sweden [4] , [5] .…”

Section: Introductionmentioning

confidence: 99%

The Prevalence and Risk Factors for Gallstone Disease in Taiwanese Vegetarians

Chen¹,

Chiou²,

Lin

et al. 2014

PLoS ONE

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IntroductionGallstone disease (GSD) and its complications are major public health issues globally. Although many community-based studies had addressed the risk factors for GSD, little is known about GSD prevalence and risk factors among Taiwanese vegetarians.MethodsThis study included 1721 vegetarians who completed a questionnaire detailing their demographics, medical history, and life-styles. GSD was ascertained by ultrasonography or surgical history of cholecystectomy for GSD. The predictive probability of GSD for male and female vegetarians was estimated from the fitted model.ResultsThe prevalence of GSD was 8.2% for both male and female vegetarians. The risk of GSD is similar in men and women across all age groups, and increases steadily with increasing age. For male vegetarians, age (OR: 1.04; 95% CI: 1.00–1.08) and serum total bilirubin level (OR: 2.35; 95% CI: 1.31–4.22) predict risk for GSD. For female vegetarians, age (OR: 1.03; 95% CI: 1.01–1.05), BMI (OR: 1.07; 95% CI: 1.01–1.13), and alcohol consumption (OR: 7.85; 95% CI: 1.83–33.73) are associated with GSD. GSD is not associated with type of vegetarian diet, duration of vegetarianism, low education level, physical inactivity, diabetes, coronary artery disease, cerebral vascular accident, chronic renal failure, hepatitis C virus infection, and lipid abnormalities. GSD is also not associated with age at menarche, postmenopausal status, and multiparity in female vegetarians.ConclusionsRisk factors useful for predicting GSD in vegetarians are (1) age and total bilirubin level in men, and (2) age, BMI, and alcohol consumption in women. Many previously identified risk factors for general population does not seem to apply to Taiwanese vegetarians.

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A Prospective, Blinded Comparison of Laparoscopic Ultrasound with Transabdominal Ultrasound for the Detection of Gallbladder Pathology in Morbidly Obese Patients

Cited by 13 publications

References 25 publications

Laparoscopic ultrasonography as an alternative to intraoperative cholangiography during laparoscopic cholecystectomy

Laparoscopic ultrasonography as an alternative to intraoperative cholangiography during laparoscopic cholecystectomy

The Accuracy of Transabdominal Ultrasound in Detection of the Common Bile Duct Stone as Compared to Endoscopic Retrograde Cholangiopancreatography (with Literature Review)

The Prevalence and Risk Factors for Gallstone Disease in Taiwanese Vegetarians

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