Assessment of Common Bile Duct Using Laparoscopic Ultrasound During Laparoscopic Cholecystectomy

Yao, Chung Chin; Huang, Shing Moo; Lin, Chun; Ho, Lu Chang; Chang, Shih Wen; Chen, Han Ming; Cheng, Ya Wen; Han, Chih-Ping

doi:10.1097/sle.0b013e3181aa6a3e

Cited by 7 publications

(7 citation statements)

References 28 publications

(31 reference statements)

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“…In comparison to IOC, LUS is less time-consuming and cheaper, but it has comparable sensitivity and specificity in terms of confirmations of anatomical relationships and the presence of bile duct stones. 8 In a study by Teefey et al IOC confirmed aberrant anatomy in 14% of the patients not found in LUS 9 ; in another study LUS detected 82% of anomalies found on IOC. 10 On the other hand, Wysocki's study found that sound surgical judgment combined with a critical view of safety (CVS) are vital to preventing BDI, and routine IOC does not fully protect against major BDI.…”

Section: Discussionmentioning

confidence: 92%

“…Laparoscopic ultrasound enables us to differentiate between vascular and avascular structures by duplex Doppler; cannulation of the cystic duct and exposure to radiation and contrast dye is avoided; it can be performed during pregnancy; it is possible to visualize the pancreatic head and possible pathology in this localization. 8 The disadvantages of LUS are undoubtedly the long learning curve, the need for special equipment and limitations to the visualization of the bile ducts. 8 Intraoperative cholangiography allows vizualization of the entire biliary tree and finding abnormal anatomic configurations.…”

Section: Discussionmentioning

confidence: 99%

“…8 The disadvantages of LUS are undoubtedly the long learning curve, the need for special equipment and limitations to the visualization of the bile ducts. 8 Intraoperative cholangiography allows vizualization of the entire biliary tree and finding abnormal anatomic configurations. In comparison to IOC, LUS is less time-consuming and cheaper, but it has comparable sensitivity and specificity in terms of confirmations of anatomical relationships and the presence of bile duct stones.…”

Section: Discussionmentioning

confidence: 99%

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Using laparoscopic ultrasound to delineate dangerous anatomy during difficult laparoscopic cholecystectomies

Sebastian¹,

Sroczyński²,

Rudnicki³

2019

Adv Clin Exp Med

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Background. Bile duct injury (BDI) during laparoscopic cholecystectomy (LC) is not as common now as in the past, but it is still a very debilitating complication. Therefore, there is a very strong need for a method that lowers the number of complications during LC without any additional risks for the patient and the operating team. Laparoscopic ultrasound (LUS), which serves to delineate anatomy, appears to be a very effective and safe technique. Objectives. The aim of this study was to explore the advantages of performing LUS during difficult LC. Material and methods. The study group consisted of 126 patients who underwent surgery between January 2014 and February 2016. All the patients had difficult intraoperative anatomical conditions due to chronic inflammation, previous upper abdominal surgery or biliary pancreatitis in the past. We used a Toshiba PEF-704 LA laparoscopic probe and the Toshiba NemioMX SSA-590A diagnostic ultrasound system (Toshiba Corp., Tokyo, Japan). Doppler sonography was used to differentiate between vascular and biliary structures. Results. Laparoscopic ultrasound ensured a safe plane of dissection and no biliary or vascular complications were observed. Stent insertion into the common bile duct before the operation undoubtedly made the identification of anatomical structures easier. Conversion to an open procedure was deemed necessary in only 6 patients (4.8%). Conclusions. Laparoscopic ultrasound facilitates the successful performance of LCs. It can be used at any time during the operation; it is noninvasive; and there is no need to use X-rays or contrast dye, or to cannulate the cystic duct. The most important advantage of LUS is that it leads to a lower number of conversions and intraoperative complications by identifying anatomical relationships in the plane of dissection.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Using laparoscopic ultrasound to delineate dangerous anatomy during difficult laparoscopic cholecystectomies

Sebastian¹,

Sroczyński²,

Rudnicki³

2019

Adv Clin Exp Med

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“…Results of majority of the studies conducted in different populations of the world in establishing role of sub hepatic drain in laparoscopic cholecystectomy patients revealed that it is associated with significant postoperative pain, increases discomfort as well as hospital stay for the patients 16,17,18. Laparoscopic cholecystectomy is primarily aimed at reducing patient’s pain, hospital stay and allows the patient a smooth and quick recovery from the operation 19,20.…”

Section: Discussionmentioning

confidence: 99%

Comparison of mean pain scores for the patients with sub hepatic drainage to those without it after elective uncomplicated laparoscopic cholecystectomy

2019

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Objective: The sub hepatic drain is often placed after laparoscopic cholecystectomy is considered to affect post operative infection, pain and sub hepatic collections. The objective of this study was to compare the degree of postoperative pain in patients with routine drainage with those without it after elective, uncomplicated laparoscopic cholecystectomy. Methods: This randomized control trial (RCT) was done over six months from 9th June 2015 to 8th December 2015 at Military Hospital Rawalpindi. Sample calculated with WHO calculator and consecutive non probability random sampling used to divide 170 patients undergoing laparoscopic cholecystectomy in two groups. One group had routine sub hepatic drain and other didn’t. Degree of postoperative pain was assessed according to VISUAL ANALOGUE SCALE by duty doctor at 24 hours. Data was collected and analyzed applying chi square test and p value was <0.05 considered statistically significant. Results: Our results demonstrated that intensity of post operative pain in routine drainage group is higher as compared to non drainage group after elective, uncomplicated laparoscopic cholecystectomy. Conclusion: Routine placement of sub hepatic drain in elective uncomplicated laparoscopic cholecystectomy should be avoided to reduce post-operative pain. How to cite this:Nadeem F, Khan MR, Naz FU. Comparison of mean pain scores for the patients with sub hepatic drainage to those without it after elective uncomplicated laparoscopic cholecystectomy. Pak J Med Sci. 2019;35(1):226-229. doi: https://doi.org/10.12669/pjms.35.1.224 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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“…The overall rate of choledocholithiasis at the time of cholecystectomy has been found to be 10 to 25%. 2,3 The mean size of common bile duct (CBD) stones has been found to be ~6 mm with ~40% of stones being <4 mm. This is important to note considering stones 4 mm or less have a high likelihood of passing spontaneously or through simple flushing of the CBD alone.…”

mentioning

confidence: 99%

Transcystic Choledochoscopy Utilizing a Disposable Choledochoscope: How We Do It

Campbell

Pryor

Docimo

2022

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Background: Biliary disease is common occurrence and can make up a large portion of the practice of a general surgeon. Choledocholithasis is a common entity amongst those with biliary disease. Although modern trends favor endoscopic retrograde cholangiopancreatography (ERCP) and other imaging modalities for the diagnosis and management of choledocholithiasis, laparoscopic common bile duct exploration (LCBDE) is likely underutilized.Methods: A literature summary utilizing a PUBMED search was performed to provide an up-to-date account regarding the latest data on LCBDE. A video identifying and explaining the critical components of a LBCDE procedure is provided.Results: LCBDE is an underutilized procedure which offers equivalent clinical outcomes compared with ERCP along with a shorter length of stay and reduced costs. LCBDE is also noted to be an effective option for common bile duct stones in the setting of altered anatomy, such as a Roux-en-Y gastric bypass. Conclusion:Although modern trends favor ERCP and other imaging modalities for the diagnosis and management of choledocholithiasis, LCBDE is likely underutilized by surgeons. LCBDE can provide many benefits to patients including avoidance of additional procedures, shorter length of stay, higher success rates, and less costs. Out video should act is a guide for those surgeons interested in implementation LCBDE in their practice.

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Assessment of Common Bile Duct Using Laparoscopic Ultrasound During Laparoscopic Cholecystectomy

Abstract: With increasing experience, LUS can become the routine method for evaluating the bile duct during LC. A more aggressive preoperative evaluation of CBD is mandated in the intermediate and high-risk groups of patients suspected of having CBD stones.

Cited by 7 publications

References 28 publications

Using laparoscopic ultrasound to delineate dangerous anatomy during difficult laparoscopic cholecystectomies

Using laparoscopic ultrasound to delineate dangerous anatomy during difficult laparoscopic cholecystectomies

Comparison of mean pain scores for the patients with sub hepatic drainage to those without it after elective uncomplicated laparoscopic cholecystectomy

Transcystic Choledochoscopy Utilizing a Disposable Choledochoscope: How We Do It

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