Technique of ultrasound examination during laparoscopic cholecystectomy

Abstract

Intracorporeal ultrasonography was used as a new method to examine the bile ducts during laparoscopic cholecystectomy. A prototype rigid 7.5-MHz ultrasound probe, 10 mm in diameter and 50 cm in length, was introduced during 25 laparoscopic cholecystectomies. A dual scanning technique was developed for complete examination of the bile duct. This entailed transverse scanning via the subxyphoid trocar and longitudinal scanning via the umbilical trocar. The intrahepatic ducts were also visualized by placing the probe on the liver surface. Color Doppler imaging was useful to quickly distinguish the duct from vascular structures. Laparoscopic ultrasonography clearly delineated the bile ducts in all operations except one. The time required for imaging was significantly shorter for ultrasonography than for cholangiography. Our preliminary experience demonstrates that a complete examination of the bile ducts can be performed with intracorporeal ultrasonography in a relatively short period of time.

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

“…12,13,15,17,[30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46] There were 4,566 patients in the IOC group and 5,044 in the LUS group.…”

“…In fact, 16 studies omitted a clear description of their inclusion criteria. 12,13,15,17,30,32,[35][36][37][38][40][41][42][43][44][45] Three studies stated clearly that they had excluded patients at high risk of CBD stones. 31,34,39 Little information was given on the experience of the surgeons performing the procedures for either LUS or IOC.…”

Der laparoskopische Ultraschall

“…Der laparoskopische Ultraschall wird bei der Gallenwegdiagnostik in erster Linie zum Steinnachweis eingesetzt [43,36,23,29]. Die Beurteilung von benignen [16] oder malignen Raumforderungen -vor allem auch des Gallenblasenkarzinoms -ist dabei eher eine Ausnahme, obwohl LUS auch dafür in hohem Maß geeignet ist [42].…”

História da ultra-sonografia intra-operatória

“…Esses transdutores tinham extremidade rígida ou flexível, podendo ser lineares, convexos ou setoriais (42) . Com o incremento do uso da vídeo-laparoscopia para o estadiamento das neoplasias do aparelho digestivo, a USIO-LAPA foi introduzida para que se implementasse a investigação desses pacientes.…”