Laparoscopic ultrasonography versus intra-operative cholangiogram for the detection of common bile duct stones during laparoscopic cholecystectomy: A meta-analysis of diagnostic accuracy

Aziz, Omer; Ashrafian, Hutan; Jones, Catherine M.; Harling, Leanne; Kumar, Sacheen; Garas, George; Holme, T C; Darzi, Ara; Zacharakis, Emmanouil; Athanasiou, Thanos

doi:10.1016/j.ijsu.2014.05.038

Cited by 54 publications

(27 citation statements)

References 29 publications

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“…It was shown that LUS was a potentially useful imaging modality to confirm the absence of CBD stones without needing to cannulate the biliary system. 8 In this study, the ability of LUS to detect and exclude gall bladder and CBD stones was examined and found to have sensitivity and specificity of 94.8% and 100% respectively, which was comparable to previous reports (80%-100%), and (98%-100%). 15,16 In another study to compare between LUS and IOC, LUS was superior to cholangiography with respect to its safety, shorter examination period, and ease of administration in all patients.…”

Section: Discussionsupporting

confidence: 85%

“…2,7 However, routine IOC during LC is often not performed because of increased operative time, radiation, and failure rate. 8 LUS is an attractive alternative with several potential advantages. The main advantages of LUS are that it does not involve ionizing radiation, is quicker to perform, has a lower failure rate and can be repeated during the procedure as required.…”

Section: Discussionmentioning

confidence: 99%

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The feasibility and accuracy of laparoscopic ultrasonography during laparoscopic cholecystectomy

Abou-Shady

2016

Int Surg J

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Background: During laparoscopic cholecystectomy (LC), intraoperative cholangiography (IOC) is currently regarded as the gold standard in the detection of choledocholithiasis. When laparoscopic ultrasonography (LUS) emerged as a viable diagnostic adjunct, it was hypothesized that its routine use would facilitate dissection, detect occult choledocholithiasis, and prevent bile duct injury (BDI) during LC. The aim of this study was to evaluate the feasibility of LUS during LC, and to evaluate its routine use in reducing bile duct complications during LC. Methods: Forty consecutive patients with gall stones disease scheduled for LC were included in this study. Initial abdominal ultrasound scan was done for all patients. LUS of the liver and the biliary system was done during LC. The success rate of the procedure, operative time, accuracy in the diagnosis of bile duct stones, and delineation of exact biliary anatomy were evaluated. Results: Forty patients (30 females and 10 males) with a mean age of 43.5 years (range, 26 to 58). The mean time required to complete the LUS examination was 11.40 minutes (range, 5 to 20). Adequate LUS visualization of the common bile duct (CBD) occurred in 40 patients (100%) and of the common hepatic duct (CHD) in 38 patients (95%). It identified 37 patients with gall bladder stones. Thus in terms of the detection and exclusion of gall bladder and common bile duct stones, the sensitivity and specificity of LUS were 94.8 percent and 100 percent respectively. LUS excluded the presence of stones in 3 cases reported to have gall stones by abdominal ultrasound (sensitivity and specificity of abdomen ultrasound were 86.5% and 100% respectively). Bile leak occurred in one patient and was treated nonoperatively. No other major bile duct injury occurred during LC. Conclusions: LUS gives better identification of vascular structures and anatomic relationship of bile duct to the portal vein and hepatic arteries. The routine use of LUS is safe and accurate and avoids biliary complications during LC.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

The feasibility and accuracy of laparoscopic ultrasonography during laparoscopic cholecystectomy

Abou-Shady

2016

Int Surg J

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“…Alternatively, laparoscopic ultrasound uses a flexible probe dressed in a sterile sheath to evaluate both ductal anatomy and the hepatic vasculature. In an attempt to try and demonstrate one method superior to the other, Aziz et al [14] performed a meta-analysis including 11 studies whose results demonstrated no significant difference in either sensitivity or specificity between each method. However, more recent studies have been able to demonstrate a higher specificity, in some cases nearly 100%, using laparoscopic ultrasound [15] .…”

Section: The Dichotomy Of Biliary Duct Imaging In Acute Cholecystitismentioning

confidence: 99%

Training vs practice: A tale of opposition in acute cholecystitis

Patel

Daly

Velasco

2015

WJH

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“…[1][2][3][4][5] Routine intraoperative cholangiography (IOC) during LC remains a controversial issue and a growing number of surgeons are abandoning it. 6 Preoperative magnetic resonance cholangiopancreatography can be used to detect choledocholithiasis that can be cleared with endoscopic retrograde cholangiopancreatography (ERCP). If choledocholithiasis is detected after a cholecystectomy, ERCP is performed postoperatively.…”

Section: Introductionmentioning

confidence: 99%

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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Laparoscopic ultrasonography versus intra-operative cholangiogram for the detection of common bile duct stones during laparoscopic cholecystectomy: A meta-analysis of diagnostic accuracy

Abstract: LUS is a potentially useful imaging modality to confirm the absence of CBD stones without needing to cannulate the biliary system.

Cited by 54 publications

References 29 publications

The feasibility and accuracy of laparoscopic ultrasonography during laparoscopic cholecystectomy

The feasibility and accuracy of laparoscopic ultrasonography during laparoscopic cholecystectomy

Training vs practice: A tale of opposition in acute cholecystitis

Using laparoscopic ultrasound to delineate dangerous anatomy during difficult laparoscopic cholecystectomies

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