Background: In the recent era of laparoscopic and robotic surgeries, preoperative imaging has become very crucial in selecting the right operative technique in any pathological condition. Though laparoscopic cholecystectomy is widely accepted and practiced surgical technique yet it has limitations especially dense pericholecystic adhesions where the surgeon requires larger field of view for optimal dissection of gall bladder bed and for optimal control of bleeding. Though ultrasonography has been in wide use for preoperative evaluation of gall bladder stone disease yet very few studies have been conducted to evaluate its role in predicting pericholecystic adhesions responsible for difficult laparoscopic cholecystectomy. Prior knowledge of dense pericholecystic adhesions may help the surgeon in opting for open over laparoscopic cholecystectomy. Methods: Out of 70 patients with gall bladder stone disease that were enrolled in the study, complete data could be obtained in only 55 patients. All patients included in the study underwent ultrasonography of abdomen in fasting state and findings were recorded including pericholecystic adhesions & visualisation of Calot's triangle. The ultrasonographic findings were compared with that of the operative findings. Results: Our study revealed that ultrasonography has more than 70% sensitivity, more than 80% specificity and more than 76% accuracy in predicting pericholecystic adhesions which is the major cause of conversion from laparoscopic to open cholecystectomy. Conclusions: Ultrasonography can serve as an inexpensive imaging tool for predicting difficult laparoscopic cholecystectomy in patients with gall bladder stone disease by demonstrating signs of pericholecystic adhesions and nonvisualisation of normal-appearing Calot's triangle.
Background: Dental implant placement has become a very common procedure in the modern era. Pre operative assessment is of immense value to ensure the long term stability of dental implants. Aim: The aim of our study was to compare the efficacy of Dental CT with radiography in planning implant surgery and pre-operative evaluation prior to implant placement. Methods: We conducted a hospital based prospective study in which patients for dental implant placement were evaluated with Dental CT and Radiography. Results: The radiographs overestimated the height of the alveolar ridge in majority of the pre implant cases as compared to Dental CT. For bucco-lingual analysis Dental CT provided an overwhelming advantage over Dental Radiography and clinical examination. The angle of alveolar ridge could not be assessed on radiographs whereas could be accurately estimated on Dental CT. Bone density of the implant site could be quantitatively determined on Dental CT whereas could not be determined on Radiographs. Conclusions: We concluded that Dental CT yields significantly better information than radiographs regarding pre-operative assessment of dental implants.
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