Laparoscopic ultrasonography as compared with static or dynamic cholangiography at laparoscopic cholecystectomy. A prospective multicenter trial.
We compared laparoscopic ultrasonography (LICU) with static (S) or dynamic (D) cholangiography (IOC) for assessment of duct anatomy an calculi in 209 patients. LICU visualized ducts in 88% compared with 93% for IOC (P = 0.046). Nineteen patients (9%) had stones: 17 were found by LICU (89%) and 10 (53%) by IOC (P = 0.032). Time to perform LICU (7 +/- 3 min) was less than IOC (13 +/- 6 min) (P < 0.0001). Time to perform SIOC (12 +/- 5 min) and DIOC (14 +/- 6 min) did not differ (P = 0.48), nor did these tests differ in accuracy. LICU provided useful anatomical information but IOC better defined anatomic anomalies. LICU required less time but was less reliable at defining anatomy and complete duct visualization. LICU was more sensitive for stones. SIOC and DIOC did not differ objectively. LICU and IOC are complementary.
Stiegmann
G V
GV
Department of Surgery, University of Colorado, Denver, USA.
Soper
N J
NJ
Filipi
C J
CJ
McIntyre
R C
RC
Callery
M P
MP
Cordova
J F
JF
D001649:Bile Duct Diseases / Q000000981:diagnostic imaging; D001652:Bile Ducts / Q000000981:diagnostic imaging / Q000473:pathology; D002758:Cholangiography; D017081:Cholecystectomy, Laparoscopic; D002769:Cholelithiasis / Q000000981:diagnostic imaging; D017558:Elective Surgical Procedures; D004564:Electrocoagulation; D005260:Female; D042882:Gallstones / Q000000981:diagnostic imaging; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013997:Time Factors; D018084:Ultrasonography, Interventional