31 August 2009
Intraoperative cholangiography in combination with laparoscopic ultrasonography for the detection of occult choledocholithiasis
Jian-Wen LiAB, Bo FengBE, Liang WuCE, Ming-Liang WangBF, Ai-Guo LuBF, Lu ZangC, Zhi-Hai MaoB, Feng DongB, Min-Hua ZhengADGMed Sci Monit 2009; 15(9): MT126-130 :: ID: 878164
Abstract
Background
There is still a debate about the utility of intraoperative cholangiography (IOC) or laparoscopic ultrasonography (LUS) for detection of occult choledocholithiasis during laparoscopic cholecystectomy (LC). The aim of this study was to assess the value of IOC combined with LUS for detection of occult common bile duct (CBD) stones at LC.
Material and Method
From Dec 2002 to Aug 2006, 103 patients with moderate risk of CBD stones underwent IOC and LUS simultaneously during LC. The physician teams for the two different procedures were blinded by each other. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio were calculated by several contingency tables that cross-tabulated the results of each technique with those of the gold standard.
Results
The success rate of IOC and LUS were 91.3% and 100% respectively and the time required for LUS was significantly shorter (P<0.01). The visualization of intrapancreatic part of CBD by IOC (97.3%) was significantly higher than LUS (73.8%). The sensitivities, specificities, accuracies, positive and negative predictive values, positive and negative likelihood rations identifying occult CBD stones were 75.0%, 98.7%, 92.2%, 95.5%, 91.4%, 57.7 and 0.253 by IOC, and 82.1%, 98.7%, 94.2%, 95.8%, 93.7%, 63.2 and 0.181 by IUS respectively. The McNemar test showed no significant difference between two methods. The sensitivity of IOC combined with LUS was 92.9%, which was greater than that of IOC and LUS taken separately.
Conclusions
LUS is usually performed in case where IOC has failed or is contraindicated. The combination of both methods maximizes intraoperative detection of occult CBD stones and should at least be recommended as two complementary methods.
Keywords: Laparoscopy - methods, Intraoperative Period - methods, Gallstones - ultrasonography, Common Bile Duct - ultrasonography, Combined Modality Therapy - methods, Choledocholithiasis - ultrasonography, Cholecystectomy, Laparoscopic - methods, Cholangiography - methods, Aged, 80 and over, Predictive Value of Tests, Ultrasonography - methods, young adult
Editorial
01 November 2024 : Editorial
Editorial: Artificial Intelligence (AI), Digital Image Analysis, and the Future of Cancer Diagnosis and PrognosisDOI: 10.12659/MSM.947038
Med Sci Monit 2024; 30:e947038
In Press
Review article
Epigenetic and Immune Mechanisms Linking Breastfeeding to Lower Breast Cancer RatesMed Sci Monit In Press; DOI: 10.12659/MSM.945451
Clinical Research
Comprehensive Analysis of Immune Infiltration and Key Genes in Peri-Implantitis Using Bioinformatics and Mo...Med Sci Monit In Press; DOI: 10.12659/MSM.941870
Clinical Research
High-Resolution Anorectal Manometry and Balloon Expulsion Test Outcomes in Functional Constipation: A Compa...Med Sci Monit In Press; DOI: 10.12659/MSM.944599
Clinical Research
Plaque Removal and Gingival Bleeding Using Biodegradable Toothbrushes: Salvadora persica, Bamboo, and Nylo...Med Sci Monit In Press; DOI: 10.12659/MSM.944469
Most Viewed Current Articles
17 Jan 2024 : Review article 6,157,120
Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron VariantDOI :10.12659/MSM.942799
Med Sci Monit 2024; 30:e942799
14 Dec 2022 : Clinical Research 1,908,619
Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase LevelsDOI :10.12659/MSM.937990
Med Sci Monit 2022; 28:e937990
16 May 2023 : Clinical Research 695,167
Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...DOI :10.12659/MSM.940387
Med Sci Monit 2023; 29:e940387
07 Jan 2022 : Meta-Analysis 260,369
Efficacy and Safety of Light Therapy as a Home Treatment for Motor and Non-Motor Symptoms of Parkinson Dise...DOI :10.12659/MSM.935074
Med Sci Monit 2022; 28:e935074