[Laparoscopic ultrasonography-assisted complicated laparoscopic cholecystectomy].
OBJECTIVE
To evaluate the role of laparoscopic ultrasonography(LUS) in prevention of bile duct injury(BDI) and residual common bile duct (CBD) calculi during complicated laparoscopic cholecystectomy (LC).


METHODS
One hundred and four cases of LC were defined complicated because of anatomic aberrance of the extrahepatic biliary system, unconfirmed exposed cystic duct, suspected CBD calculi or BDI, adhesion or inflammation in the Calot's triangle, acute cholecystitis, and atrophic gallbladder. LUS was performed to scan the extrahepatic bile duct. LC was carried out with assistance of the LUS.


RESULTS
Assisted with the LUS demonstrated anatomic relationship between the extrahepatic bile duct and cystic infundibulum or cystic duct, 85 cases of LC were accomplished successfully. 19 were converted to open cholecystectomy because of LUS-indicated potential risk of BDI, CBD calculi, and suspected BDI.


CONCLUSIONS
With the extrahepatic bile duct visualized by LUS and contrast of the cystic infundibulum and cystic duct, operators can precisely identify the anatomic relationships between the cystic infundibulum, cystic duct and extrahepatic bile duct. Preoperatively unpredicted choledocholithiasis may be recognized.
Department of Hepatobiliary Surgery, Kunming General Hospital of Chengdu Command, People's Liberation Army, Kunming 650032 China.diglower@sohu.com
Ding
D
Luo
Xunru
X
Chen
Shenghong
S
Li
Jingxi
J
Mao
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017734:Bile Ducts, Extrahepatic / Q000000981:diagnostic imaging*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000379:methods*; D003549:Cystic Duct / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D014463:Ultrasonography