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Background: The aim of the study was a prospective randomized comparison of Laparoscopic Intraoperative Ultrasonography (LIOU) and dynamic Intraoperative Cholagiography (IOC) douring Laparoscopic Cholecystectomy (LC). Methods: In 518 consecutive patients scheduled for Laparoscopic Cholecystectomy LIOU and IOC were attempted. The order in which the diagnostic procedures were performed was randomly assigned. Results: LIOU failed in 2 patients (0.4%) and there were 41 (7.9%) fialed IOC´s. The common bile duct (CBD) were visualized reliably with both methods. In our patients we have found sensitivities of 83.3% and 100%, specificities of 100% and 98.9%, with an overall accuracy of 99.2% and 98.9% for LIOU as compared to IOC for identifying unsuspected common bile duct stones. The time necesary for the examination was significantly shorter in LIOU than in IOC (7 vs 16 min). Conclusions: LIOU performed by experienced surgeons is a good and effective method to assess the CBD including the neoghboring structures of hepatoduodenal ligament. Using powerful, flexible-tip ultrasound probes CBD-exploration can be done reproducable in longitudinal fashion, which is necesary for good anatomical clarity. No adverse effects, short examination times and less costs are advantages of this method. The most important advantage is the posiblity of unlimited repetition, especially if there is difficulty identifying anatomic structures. There are some indications that LIOU has the potential to recognize major iatrogenic bile duct injuries.

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2004-08-03   |   1,088 visitas   |   Evalua este artículo 0 valoraciones

Vol. 18 Núm.1. Enero-Diciembre 2002 Pags. 9 Med Hoy 2002; 18(1)