The Peroperative Use of Real-Time B-Mode Ultrasound Imaging in Biliary and Pancreatic Surgery

Jakimowicz, Jack J.; Carol, E.J.; Jurgens, Paul T.

doi:10.1159/000171640

Cited by 14 publications

(2 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The final evaluation of the cost-effectiveness is strictly dependent on local situations, levels of hospital cost, physician fees, and cost of equipment. Based on the local situation in The Netherlands and in our institution, we have calculated [26] that the potential savings resulting from use of operative sonography as a routine diagnostic procedure in the current series of patients would allow the purchase of 2 ultrasound scanners such as those used in the current series. Routine cholangiography also appears to be cost-effective, but marginally so.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of operative ultrasonography and radiography in screening of the common bile duct for calculi

et al. 1987

View full text Add to dashboard Cite

We report a 4-year experience of operative ultrasonography in 449 patients who underwent cholecystectomy for biliary lithiasis. Intraoperative uttrasonography and intraoperative cholangiography were performed in all of these patients and compared with the operative findings. The diagnostic accuracy of sonography was 97.5% and that of chalangiography was 94.4% in the patient group as a whole. The predictive value of a positive sonogram in this group was 96.4%, while that of a positive cholangiogram was lower at 86.9%. In 148 patients who underwent surgical exploration of the common duct, sonography appeared to have more accurately predicted presence or absence of stones (92.5 %) than did cholangiography (79.8%). Use of these intraoperative screening tests together led to a positive common duct exploration in 76.6% of the 148 patients, which is higher than our previous experience in which common duct exploration was performed on the basis of clinical criteria. In 7% of the 301 cholecystectomized patients, nnpredicted stones were detected at operative sonography and cholangiography. If the common duct exploration were to be performed based solely on the outcome of the sonogram, the rate of positive exploration could be 97%. Overall morbidity in this series was 9%, and retained stones following duct exploration were encountered in 1 patient. The overall mortality rate of the entire patient group was 0.9%. Operative ultrasonography of the biiiary tract as a screening procedure is, in experienced hands, a reliable method and substitute for operative cholangiography.

show abstract

Section: Discussionmentioning

confidence: 99%

“…The technique of biliary operative sonography has been reported in detail [2,17,18]. The main points are:…”

Section: Methodsmentioning

confidence: 99%

Comparison of operative ultrasonography and radiography in screening of the common bile duct for calculi

et al. 1987

View full text Add to dashboard Cite

show abstract

Contact ultrasonography in the detection of liver metastases from colorectal cancer: An in vitro study

Thomas

Morris

Hardcastle

1987

Journal of British Surgery

View full text Add to dashboard Cite

Occult hepatic metastases (OHM) may be present in a quarter of patients undergoing apparently curvative surgery for colorectal cancer'.Apart from the encouraging Glasgow experience of serial ultrasound and CT which detected OHM in > 20 per cent of patients', the other promising means of detecting OHM is the hepatic perfusion index, which produces a dynamic radioisotope hepatic scan in which the arterial and venous phases of hepatic blood supply are studied and compared with those of the kidney. It seems that patients with an abnormal HPI usually go on to develop obvious hepatic metastases'. Intra-operative contact ultrasound (CUS) is a relatively new technique which has been advocated for the detection of occult hepatic metastases. The aim of our study in uitro was to try and define the minimum diameter of hepatic metastases which CUS can detect. Materials and methodsTwenty livers were removed at necropsy within 24 h of death from patients with proven malignant disease and scanned immediately. All patients had histologically confirmed gastric or colorectal adenocarcinoma. The livers were pre-marked with sutures at 1 cm intervals on each side of the liver and these were then connected by parallel intervening sutures ( Figure I). The livers were then systematically scanned along these defined planes, the presence of any metastases was noted and their diameter and depth from the liver surface measured. Following imaging the liver was sectioned along exactly the same parallel lines. The number, diameter and site of metastases visible in the cut section was recorded.The machine used for this study was a Bruel and Kraer type 1846 ultrasound scanner together with 3 and 5 MHz transducers (dual head sector transducer 8529). Both transducers were used although all copies were made with the 5 MHz machine; ultrasound jelly was used to improve contact between the transducer and the liver. Copies of the images were made using an X-ray plate system. ResultsOf the 20 livers imaged 11 were found to contain metastases. The 5 MHz transducer was found to be much more suitable for contact ultrasound scanning of the liver producing much cleaner definition and the reduced depth of imaging was not found to be a disadvantage in this situation. All data and figures relate to the 5 MHz transducer. In four of the livers the number of hepatic metastases was so extensive as to make accurate determination of the number of metastases in some planes impossible and these planes were excluded. In the remaining sections which we imaged 67 metastases were found and 45 of these were detected by CUS (67 per cent); all the metastases appeared hyperechoic (Figure 2). Of the 37 metastases of 1 cm in diameter or greater, 95percent were detected ( Table 1). No diameter of metastases with a rule in the same planes after slicing a vertical section ofthe liver along the planes marked in a metastases of <0.5cm in diameter were detected; 10 of 15 metastases between 0.5 and 0.9cm were imaged. The measurement of diameter and depth of metastases by CUS was found t...

show abstract

Intraoperative Sonographie

Harms

Siewert

Stadler

et al. 2000

Viszeralchirurgische Sonographie

View full text Add to dashboard Cite

The Peroperative Use of Real-Time B-Mode Ultrasound Imaging in Biliary and Pancreatic Surgery

Abstract: The current state of the use of ultrasound imaging during biliary and pancreatic surgery is discussed. Special attention is drawn to the peroperative application of ultrasound for the peroperative screening of the common bile duct. The advantages and drawbacks of this method are discussed.

Cited by 14 publications

References 7 publications

Comparison of operative ultrasonography and radiography in screening of the common bile duct for calculi

Comparison of operative ultrasonography and radiography in screening of the common bile duct for calculi

Contact ultrasonography in the detection of liver metastases from colorectal cancer: An in vitro study

Intraoperative Sonographie

Contact Info

Product

Resources

About