A prospective single-blinded controlled study comparing laparoscopic ultrasound of the common bile duct with operative cholangiography

Abstract

Laparoscopic ultrasound examination of the bile duct is superior to operative cholangiography and could replace it.

Intraoperative ultrasound as an educational guide for laparoscopic biliary surgery

“…Moreover, it does not require new X-ray apparatus, radiologists, or laboratory technicians. Many studies, including two randomized control trials, have reported that visualization of the biliary tract anatomy and diagnostic performance of IOUS for bile duct stones are as high, or better, than those for cholangiography [17,[21][22][23] . It has also been reported that IOUS decreases the necessity to perform cholangiography [29,30] .…”

“…On the other hand, IOUS requires a shorter examination time [17][18][19] , is safe without incurring radiation exposure, www.wjgnet.com and is minimally invasive [18,20] . It has been reported that IOUS allows for visualization equal to or better than that of cholangiography [17,[20][21][22][23] in the case of biliary anatomy and diagnosis of bile duct stones. However, there have been few studies that have investigated whether the routine implementation of IOUS decreases BDI during LC [24] .…”

Choledocholithiasis

“…Die laparoskopische Sonographie erreicht mit einer Spezifität von bis zu 100% bei einer Sensitivität von 96% ähnlich gute Ergebnisse wie die IOC bei der Diagnostik der Choledocholithiasis [11] [12]. Mit Ablösung der offenen Cholezystektomie als Standardverfahren bei der Cholezystektomie ist die Debatte über die notwendige intraoperative Gallengangsdarstellung mittels Cholangiographie oder Sonographie fortgesetzt worden.…”

Training vs practice: A tale of opposition in acute cholecystitis

“…In an attempt to try and demonstrate one method superior to the other, Aziz et al [14] performed a meta-analysis including 11 studies whose results demonstrated no significant difference in either sensitivity or specificity between each method. However, more recent studies have been able to demonstrate a higher specificity, in some cases nearly 100%, using laparoscopic ultrasound [15] . Additional advantages to LUS include that it is efficient, does not require cannulating the biliary system, and it can be accomplished prior to a complete and sometimes tedious dissection as it is easily repeated as needed during the course of an operation.…”

“…Additional advantages to LUS include that it is efficient, does not require cannulating the biliary system, and it can be accomplished prior to a complete and sometimes tedious dissection as it is easily repeated as needed during the course of an operation. Furthermore, LUS does not require fluoroscopy, and it has a lower failure rate than IOC, being extremely useful in defining the hepaticoduodenal anatomy [15][16][17] . In spite of these many benefits, LUS is rarely taught and rarely utilized in practice because of the technique's large learning curve and the traditional acceptance of IOC as best care.…”