A prospective comparison of laparoscopic ultrasound vs intraoperative cholangiogram during laparoscopic cholecystectomy

1999 ◽  
Vol 13 (8) ◽  
pp. 784-788 ◽  
Author(s):  
R. A. Falcone, ◽  
E. J. Fegelman ◽  
M. S. Nussbaum ◽  
D. L. Brown ◽  
T. M. Bebbe ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Ultrasound ◽  
Intraoperative Cholangiogram ◽  
Prospective Comparison

Analysis of Endoscopic Retrograde Cholangiopancreatography after Positive Intraoperative Cholangiogram: Is it Necessary?

2016 ◽  
Vol 82 (10) ◽  
pp. 985-988
Author(s):  
John V. Gahagan ◽  
Steven Maximus ◽  
Matthew D. Whealon ◽  
Michael J. Phelan ◽  
Aram Demirjian ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Acute Cholecystitis ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Nationwide Inpatient Sample ◽  
Bile Duct Stone ◽  
Stone Extraction ◽  
Endoscopic Retrograde ◽  
Intraoperative Cholangiogram ◽  
Nationwide Inpatient Sample Database

The necessity of routine endoscopic retrograde cholangiopancreatography (ERCP) after positive intraoperative cholangiogram (IOC) during laparoscopic cholecystectomy is not well defined. We aimed to examine the incidence of positive IOC among patients who undergo IOC during cholecystectomy and the rate of subsequent ERCP stone extraction. The Nationwide Inpatient Sample database was reviewed for all patients undergoing cholecystectomy with IOC from 2002 to 2012. Patients were then analyzed for ERCP and stone extraction. A total of 73,508 patients who underwent cholecystectomy with IOC for a diagnosis of acute cholecystitis and found to have a bile duct stone were identified. Of these patients, 5915 underwent subsequent ERCP. In the patients that underwent subsequent ERCP, 1478 had a documented stone extraction during ERCP. The rate of stone extraction in the ERCP subset is 25 per cent, which is 2 per cent of all patients who had a positive IOC. The rate of stone extraction after positive IOC is low. Positive IOC may not warrant a routine postoperative ERCP. Our results suggest that clinical monitoring of patients with positive IOC is reasonable, as the majority of patients with a positive IOC ultimately have no stone extraction.

scholarly journals Navigation with laparoscopic ultrasound during fundus-first laparoscopic cholecystectomy-a single-centre retrospective case control study

2020 ◽  
Author(s):  
Maciej Sebastian ◽  
Agata Sebastian ◽  
Jerzy Rudnicki
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Statistical Significance ◽  
Laparoscopic Ultrasound ◽  
Retrospective Case ◽  
Exact Test ◽  
Critical View ◽  
Critical View Of Safety ◽  
The Mean ◽  
Mean Time ◽  
Bail Out

Abstract Background Laparoscopic cholecystectomy is considered as the gold standard treatment for cholecystolithiasis. The critical view of safety is a generally accepted technique of intraoperative visualization but during inflammation and fibrosis in the region of Calot’s triangle it may fail. Fundus-first laparoscopic cholecystectomy with laparoscopic ultrasound navigation may be an attractive bail-out option when the intraoperative conditions are difficult. Methods The study group consisted of 900 patients with symptomatic cholecystolithiasis which was divided into two subgroups. The first subgroup where the only method of intraoperative identification was the critical view of safety consisted of 402 patients, the second subgroup where the critical view of safety and laparoscopic ultrasound were used consisted of 498 patients. In the first subgroup fundus-first laparoscopic cholecystectomy was performed in 13 patients, in the second subgroup in 42 patients. Statistical analysis included the Mann-Whitney U test for continuous and Fisher’s exact test for binary variables. The level of statistical significance was set at 95% (p < 0.05). Results Fundus-first technique was significantly more often in the subgroup with laparoscopic ultrasound and the hospitalization time of fundus-first laparoscopic cholecystectomies was significantly shorter than in converted cases. The mean time of laparoscopic cholecystectomy and the mean time to obtain the transection level between the gallbladder and the hepatoduodenal ligament were significantly shorter and the conversion rate was significantly lower in the fundus-first and laparoscopic ultrasound group. Conclusions Fundus-first technique with laparoscopic ultrasound navigation may be a very efficient bail-out option during laparoscopic cholecystectomy due to a more precisely and significantly faster defined plane of dissection what enables safe performance of laparoscopic cholecystectomy with significantly lower rate of conversions.

Feasibility of Laparoscopic Intraoperative Cholangiogram in Patients with Intermediate Risk for Choledocholithiasis

2021 ◽  
Vol 8 (02) ◽  
pp. 108-114
Author(s):  
Adithya G.K. ◽  
Satya Prakash Jindal ◽  
Varun Madaan ◽  
Vachan Hukkeri ◽  
Rigved Gupta ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Liver Function ◽  
Liver Function Tests ◽  
Filling Defect ◽  
Primary Objective ◽  
Intermediate Risk ◽  
Intraoperative Cholangiogram ◽  
History Of ◽  
Technical Issues

BACKGROUND Intra-Operative Cholangiogram (IOC) is a procedure carried out during cholecystectomy with the primary objective of clearly delineating the biliary anatomy. Over decades, routine IOC became selective IOC and now it is being overtaken by less invasive investigations like MRCP and EUS. Role of IOC remains only to intraoperatively confirm or rule out bile duct injury in difficult cases. Laparoscopic IOC is a skilful procedure which requires training and extra added time during laparoscopic cholecystectomy. Once mastered it can be used in many situations for either anatomical reasons or to detect CBD pathology. METHODS All patients getting admitted for laparoscopic cholecystectomy with intermediate risk for choledocholithiasis were enrolled in the study from 2016 to 2019. Procedure was carried out with all necessary consents and precautions. All cases were performed by an experienced GI surgeon and followed up with proper protocol. RESULTS Fifty patients with known intermediate risk for choledocholithiasis underwent laparoscopic cholecystectomy with laparoscopic IOC. Procedure was successfully done in all patients except two, where cystic duct was very thin and cannulation was not possible. Forty-one (82%) patients had deranged liver function test and 9 patients (18%) had history of acute pancreatitis in the past as indications for the procedure. Two patients had dilated CBD (>6 mm) on ultrasound along with deranged liver function tests. An average of 12 minutes was taken to perform the procedure (range: 8 - 15 min). In cases where IOC took longer time was mainly due to technical issues (operability of C-arm). No IOC related complications occurred in any of the patients. Hospital stay was not prolonged in any of the patients due to IOC. None of the patients had any filling defect in CBD. All cases followed till date are asymptomatic. CONCLUSIONS It is a technically feasible procedure that can be performed with limited addition to OT time, minimal failure rate, and complications. All patients with limited criteria for intermediate risk of choledocholithiasis had a normal IOC with no evidence of biliary obstruction in follow up. KEYWORDS Laparoscopic Intraoperative Cholangiogram, Intermediate Risk, CBD Stones

A comparison of laparoscopic ultrasound with digital fluorocholangiography for detecting choledocholithiasis during laparoscopic cholecystectomy

1998 ◽  
Vol 12 (7) ◽  
pp. 929-932 ◽  
Author(s):  
D. M. Thompson ◽  
M. E. Arregui ◽  
C. Tetik ◽  
M. T. Madden ◽  
M. Wegener
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Ultrasound

Assessment of Common Bile Duct Using Laparoscopic Ultrasound During Laparoscopic Cholecystectomy

2009 ◽  
Vol 19 (4) ◽  
pp. 317-320 ◽  
Author(s):  
Chung-Chin Yao ◽  
Shing-Moo Huang ◽  
Chun-Che Lin ◽  
Lu-Chang Ho ◽  
Shih-Wen Chang ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Laparoscopic Ultrasound

Single-access laparoscopic cholecystectomy with routine intraoperative cholangiogram

2010 ◽  
Vol 25 (5) ◽  
pp. 1683-1688 ◽  
Author(s):  
Melissa B. Bagloo ◽  
Gregory F. Dakin ◽  
Lori P. Mormino ◽  
Alfons Pomp
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Single Access ◽  
Intraoperative Cholangiogram

scholarly journals Outcomes From Routine Use of Intraoperative Cholangiogram in Laparoscopic Cholecystectomy: Factors Predicting Benefit From Selective Cholangiography

Cureus ◽  
2021 ◽  
Author(s):  
Akinfemi Akingboye ◽  
Fahad Mahmood ◽  
Marriam Ahmed ◽  
Kishan Rajdev ◽  
Osama Zaman ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Intraoperative Cholangiogram
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