Intra-operative cholangiography and ultrasonography were compared in screening for unsuspected common bile duct stones. In 57 consecutive patients both procedures were performed, and in 60 only ultrasonography was used. Although the study was conducted during the initial self-teaching period (regarding ultrasonography) the results show an advantage of this relatively new diagnostic technique. The false positive rate was lower and consequently the predictive value of a positive test was higher for intraoperative ultrasonography. The main benefit would thus be a lower rate of negative common bile duct explorations. Our early results suggest that the general surgeon would need only a short adaptation period to this imaging modality, which would seem to be a valuable alternative to intra-operative cholangiography.
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Kathmandu Univ Med J (KUMJ)
September 2024
Department of Gastrointestinal and General Surgery, Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal.
Background Advances in surgery have decreased postoperative morbidities but bile leak is still a major issue. Intraoperative cholangiogram (IOC) is considered better in identifying bile leaks and anatomical delineation making its expanded use in hepato-biliary surgeries. Objective To assess the role of intraoperative cholangiogram in major hepatectomy and complex bilio-enteric bypass surgery.
View Article and Find Full Text PDFN Z Med J
May 2024
Radiology, Waikato Hospital, Te Whatu Ora - Health New Zealand Waikato, Hamilton, New Zealand.
Aims: The aim of this study was to investigate the outcome of common bile duct stones (CBDS) in asymptomatic patients at laparoscopic cholecystectomy (LC) and intra-operative cholangiogram (IOC).
Methods: All patients undergoing LC and IOC at Te Whatu Ora - Health New Zealand Waikato between January 2017 and January 2022 were retrospectively reviewed. Electronic records were screened for asymptomatic CBDS.
J Minim Access Surg
January 2024
Department of Surgery, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.
Introduction: The most dreaded complication during laparoscopic cholecystectomy still remains to be injury to the common bile duct. The primary cause for bile duct injury during LC is misinterpretation of the biliary anatomy. Intra-operative cholangiography was introduced as a means of reducing the chances of biliary injury, done using Fluoroscopic imaging or Near-infrared fluorescence imaging method.
View Article and Find Full Text PDFANZ J Surg
March 2024
Department of Upper GI Surgery, Concord Repatriation General Hospital, Concord, New South Wales, Australia.
Backgrounds: Laparoscopic common bile duct exploration (LCBDE) has been shown to be effective in managing choledocholithiasis whilst avoiding ERCP-related complications. However, patient and technical factors effects outcome. This study aimed to explore the matters effecting the failure of LCBDE.
View Article and Find Full Text PDFJ Robot Surg
December 2023
Department of Upper GI Surgery, Queen Alexandra Hospital, Portsmouth Hospitals University NHS Trust, Portsmouth, UK.
Image-guided assessment of bile ducts and associated anatomy during laparoscopic cholecystectomy can be achieved with intra-operative cholangiography (IOC) or laparoscopic ultrasound (LUS). Rates of robotically assisted cholecystectomy (RC) are increasing and herein we describe the technique of intra-corporeal biliary ultrasound during RC using the Da Vinci system. For intraoperative evaluation of the biliary tree during RC, in cases of suspected choledocholithiasis, the L51K Ultrasound Probe (Hitachi, Tokyo, Japan) is used.
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