Laparoscopy-guided intracorporeal ultrasound accurately delineates hepatobiliary anatomy.
The purpose of this study was to develop a technique and assess the ability of a laparoscopic ultrasound probe to delineate biliary antomy and to determine the presence or absence of duct stones.


METHODS
Five pigs had ultrasonography of biliary structures and liver at laparoscopy followed by cholangiograms and anatomical dissection. Five patients had ultrasonography of the biliary tract at laparoscopic cholecystectomy.


RESULTS
All animals had adequate visualization of important hepatobiliary structure, and an optimal method of accessing these structures at laparoscopy was established. Patients had ultrasonography which used methods developed in the animal trial. All had adequate visualization of the entire common bile duct confirmed by cholangiography. Limitations in demonstrating the relationship of the cystic duct to the common duct were technical and can be corrected.


CONCLUSIONS
Laparoscopic ultrasonography has significant potential for delineation of biliary anatomy and determination of presence or absence of duct calculi. Clinical implementation could minimize the risk of iatrogenic duct injury and the need for operative cholangiography.
Yamamoto
M
M
Department of Surgery, Aoto Hospital, Jikei University School of Medicine, Tokyo, Japan.
Stiegmann
G V
GV
Durham
J
J
Berguer
R
R
Oba
Y
Y
Fujiyama
Y
Y
McIntyre
R C
RC
D000818:Animals; D001649:Bile Duct Diseases / Q000000981:diagnostic imaging; D001659:Biliary Tract / Q000000981:diagnostic imaging*; D002758:Cholangiography; D017081:Cholecystectomy, Laparoscopic; D002769:Cholelithiasis / Q000000981:diagnostic imaging; D042882:Gallstones / Q000000981:diagnostic imaging; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D010535:Laparoscopy; D008099:Liver / Q000000981:diagnostic imaging*; D013552:Swine; D014463:Ultrasonography