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A prospective comparison of laparoscopic ultrasound vs intraoperative cholangiogram during laparoscopic cholecystectomy. 1999

R A Falcone, and E J Fegelman, and M S Nussbaum, and D L Brown, and T M Bebbe, and G L Merhar, and J A Johannigman, and F A Luchette, and K Davis, and J M Hurst
College of Medicine, Department of Surgery, University of Cincinnati Medical Center, Post Office Box 670558, Cincinnati, OH 45267, USA.

BACKGROUND The laparoscopic ultrasound (US) probe provides a new modality for evaluating biliary anatomy during laparoscopic cholecystectomy (LC). METHODS We performed a laparoscopic US examination in 65 patients without suspected common bile duct (CBD) stones prior to the performance of a laparoscopic cholangiogram (IOC). We then compared the cost, time required, surgeon's assessment of difficulty, and interpretations of findings. RESULTS There was a significant difference in the cost of US versus the cost of IOC ($362 +/- 12 versus $665 +/- 12; p < 0.05). Surgeons who had performed >10 US (EXP) were compared with those who had performed </=10 (NOV). There were significant differences between the EXP and NOV groups in ease of examination, visualization of biliary anatomy, and accuracy of measurement of the CBD. CONCLUSIONS The use of laparoscopic US for the accurate evaluation of the CBD and biliary anatomy requires that the surgeon has surpassed the learning curve, which we have defined as having performed >10 US exams.

UI MeSH Term Description Entries
D007432 Intraoperative Period The period during a surgical operation. Intraoperative Periods,Period, Intraoperative,Periods, Intraoperative
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D002758 Cholangiography An imaging test of the BILIARY TRACT in which a contrast dye (RADIOPAQUE MEDIA) is injected into the BILE DUCT and x-ray pictures are taken. Cholangiographies
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D001659 Biliary Tract The BILE DUCTS and the GALLBLADDER. Biliary System,Biliary Tree,System, Biliary,Tract, Biliary,Tree, Biliary

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