Surgeon-performed point-of-care ultrasound for acute cholecystitis: indications and limitations: a European Society for Trauma and Emergency Surgery (ESTES) consensus statement

Pereira, Jorge; Bass, Gary Alan; Mariani, Diego; Bd, Dumbrava; Casamassima, Andrea; Ar, da Silva; Pinheiro, Luís Filipe; Martínez-Casas, Isidro; Zago, Mauro

doi:10.1007/s00068-019-01197-z

Cited by 20 publications

(17 citation statements)

References 74 publications

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“…Several reports have tried to provide a link between increased blood flow in the gallbladder and acute cholecystitis. Nevertheless, this technique has yet not gained wide acceptance, and experts are hesitant to suggest its application (12). Parameters utilized to quantify hyperemia include PI, peak velocity and resistance index.…”

Section: Resultsmentioning

confidence: 99%

Is There a Role for Color Doppler Ultrasonography in Acute Cholecystitis?

Perysinakis¹,

Spartinou²,

Savvides³

et al. 2020

ama

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Objective. The aim of this study was to evaluate the utility of the Pulsatility Index (PI) of the right hepatic artery, measured by color Doppler sonography, in the diagnosis of acute cholecystitis.Methods. Seventy-five subjects were included in this study and divided into three groups, each consisting of 25 subjects: the cholecystitis group, the asymptomatic cholelithiasis group, and normal controls. Patients with acute cholecystitis fulfilled all the diagnostic criteria as stated in the latest Tokyo Guidelines. In all patients, the right hepatic artery was detected by color Doppler ultrasound and the PI was measured.Results. Patients with acute cholecystitis were found to have significantly higher PI values compared to both normal controls and cholelithiasis patients. Regression analysis revealed a significant positive correlation between the PI and the cholecystitis outcome.Conclusion. Measurement of PI by color Doppler ultrasound represents a useful aid in the diagnostic process of acute cholecystitis. More studies are needed before this method is incorporated in the relevant guidelines.

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Section: Resultsmentioning

confidence: 99%

Is There a Role for Color Doppler Ultrasonography in Acute Cholecystitis?

Perysinakis¹,

Spartinou²,

Savvides³

et al. 2020

ama

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“…With the recent development of high-frequency ultrasonography transducers, the role of ultrasonography in orthopaedic surgery, not only as a diagnostic tool but also as a therapeutic and research tool, has been increasingly recognized [34]. Similar to other medical fields [35], surgeonperformed ultrasonography has become increasingly common among orthopaedic surgeons. However, we acknowledge that it would be difficult for many orthopaedic surgeons to perform ultrasonography on a routine basis due to limited time, cost, and experience.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of avulsion fractures of the distal fibula after lateral ankle sprain in children: a diagnostic accuracy study comparing ultrasonography with radiography

Takakura¹,

Yamaguchi

Akagi

et al. 2020

BMC Musculoskelet Disord

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Background: The purpose of this study was to determine the diagnostic accuracy of ultrasonography for the diagnosis of avulsion fractures of the distal fibula for lateral ankle sprain in children and compare it to that of radiography. Methods: Children who sustained lateral ankle sprain were prospectively surveyed. They underwent both ultrasonography and radiography at the first clinic visit to diagnose any concomitant avulsion fractures of the distal fibula. The patients underwent follow-up radiography 4 weeks later to obtain the reference standard diagnosis. The measures of diagnostic accuracy (i.e., sensitivity, specificity, positive predictive value, and negative predictive value) of the initial ultrasonography and radiography were calculated; they were then compared using the McNemar test. Totally, 52 patients (with a median age of 9 years) were analyzed. Results: On the reference standard (follow-up) radiographs, 32 patients (62%) were found to have avulsion fractures of the distal fibula. The sensitivity, specificity, positive predictive value, and negative predictive value for ultrasonography were 94, 85, 91, and 89% respectively; and 81, 100, 100, and 77% respectively for radiography at the first visit. There were no significant differences in sensitivity and specificity between the two diagnostic methods (P = 0.22, 0.25). Conclusions: Ultrasonography has a high diagnostic accuracy, which is comparable to that of radiography, for the diagnosis of avulsion fracture of the distal fibula. Ultrasonography may be used as an option of imaging modality for lateral ankle sprain in children.

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“…Similarly, ultrasonographic Murphy’s sign has widely varying sensitivity and specificity for diagnosis according to the characteristics of the evaluation performed; depending on criteria and the patient cohort, it has been found to be either highly sensitive or specific for diagnosis of acute cholecystitis, but not both [ 69 ]. While clearly the appropriate diagnostic technology for patient assessment [ 82 ], it is likely that the judgement of Bree in 1995 still stands: “ The large number of false positives, and only moderate improvement in specificity when accompanied by gallstones, makes this sign unreliable in separating acute from chronic cholecystitis .” [ 83 ].…”

Section: Symptoms and Diagnosismentioning

confidence: 99%

The Need for Standardizing Diagnosis, Treatment and Clinical Care of Cholecystitis and Biliary Colic in Gallbladder Disease

et al. 2022

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Gallstones affect 20% of the Western population and will grow in clinical significance as obesity and metabolic diseases become more prevalent. Gallbladder removal (cholecystectomy) is a common treatment for diseases caused by gallstones, with 1.2 million surgeries in the US each year, each costing USD 10,000. Gallbladder disease has a significant impact on the logistics and economics of healthcare. We discuss the two most common presentations of gallbladder disease (biliary colic and cholecystitis) and their pathophysiology, risk factors, signs and symptoms. We discuss the factors that affect clinical care, including diagnosis, treatment outcomes, surgical risk factors, quality of life and cost-efficacy. We highlight the importance of standardised guidelines and objective scoring systems in improving quality, consistency and compatibility across healthcare providers and in improving patient outcomes, collaborative opportunities and the cost-effectiveness of treatment. Guidelines and scoring only exist in select areas of the care pathway. Opportunities exist elsewhere in the care pathway.

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Surgeon-performed point-of-care ultrasound for acute cholecystitis: indications and limitations: a European Society for Trauma and Emergency Surgery (ESTES) consensus statement

Cited by 20 publications

References 74 publications

Is There a Role for Color Doppler Ultrasonography in Acute Cholecystitis?

Is There a Role for Color Doppler Ultrasonography in Acute Cholecystitis?

Diagnosis of avulsion fractures of the distal fibula after lateral ankle sprain in children: a diagnostic accuracy study comparing ultrasonography with radiography

The Need for Standardizing Diagnosis, Treatment and Clinical Care of Cholecystitis and Biliary Colic in Gallbladder Disease

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