Intraoperative ultrasound as an educational guide for laparoscopic biliary surgery.

World Journal of Gastroenterology : WJG
Kenichi HakamadaMutsuo Sasaki

Abstract

To analyze the efficacy of routine intraoperative ultrasound (IOUS) as a guide for understanding biliary tract anatomy, to avoid bile duct injury (BDI) after laparoscopic cholecystectomy (LC), as well as any burden during the learning period. A retrospective analysis was performed using 644 consecutive patients who underwent LC from 1991 to 2006. An educational program with the use of IOUS as an operative guide has been used in 276 cases since 1998. IOUS was highly feasible even in patients with high-grade cholecystitis. No BDI was observed after the introduction of the educational program, despite 72% of operations being performed by inexperienced surgeons. Incidences of other morbidity, mortality, and late complications were comparable before and after the introduction of routine IOUS. However, the operation time was significantly extended after the educational program began (P < 0.001), and the grade of laparoscopic cholecystitis (P = 0.002), use of IOUS (P = 0.01), and the experience of the surgeons (P = 0.05) were significant factors for extending the length of operation. IOUS during LC was found to be a highly feasible modality, which provided accurate, real-time information about the biliary structures. The educational p...Continue Reading

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Citations

Aug 14, 2010·Surgical Endoscopy·D Wayne OverbyUNKNOWN Society of American Gastrointestinal and Endoscopic Surgeons
Nov 7, 2014·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Li-Xia LiYong-Yang Li
Aug 31, 2010·Journal of the American College of Surgeons·Javairiah FatimaMichael B Farnell
Aug 26, 2017·World Journal of Gastroenterology : WJG·Alexandra Dili, Claude Bertrand
May 15, 2020·Annals of Surgery·L Michael BruntUNKNOWN and the Prevention of Bile Duct Injury Consensus Work Group
May 14, 2020·Surgical Endoscopy·L Michael BruntUNKNOWN Prevention of Bile Duct Injury Consensus Work Group

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