Ahmed Abdelhakim, Alsayed Hamdy, Ahmed Ahmed, Ahmed Abo Elfottoh
{"title":"腹腔镜胆囊切除术中手术超声波检查和围手术期胆管造影检查胆总管结石的比较研究","authors":"Ahmed Abdelhakim, Alsayed Hamdy, Ahmed Ahmed, Ahmed Abo Elfottoh","doi":"10.21608/ijma.2023.236794.1815","DOIUrl":null,"url":null,"abstract":"Article information Background: The routine uses of intraoperative cholangiography [IOC] is still controversial. Some authors support routine IOC, while others favor selective IOC. The operative ultrasonography [OUS] probe provides a new modality for evaluating biliary anatomy and detection of Choledocholithiasis during laparoscopic cholecystectomy. It is considered a faster, safer, and non-invasive technique. Aim of the Study: This study aims to compare the accuracy of operative ultrasonography [OUS] and IOC in the detection of common bile duct stones during laparoscopic cholecystectomy. Patients and Methods: This prospective comparative study included 50 patients who underwent laparoscopic cholecystectomies with or without bile duct exploration, which was done at El-Hussein University Hospital in the period from March 2018 to December 2019. Operative laparoscopic ultrasonography was performed followed by an operative cholangiogram. Bile ducts were explored if CBD stones were seen and the patients were followed up by clinical evaluation, laboratory investigations, and abdominal ultrasound within one month from surgery. Results: The IOUS timing which was the time after identification of the cystic duct and artery till the start of IOC, was significantly lower than the IOC Timing which was the time After IOUS till clipping of the proximal part of the cystic duct. The sensitivity and specificity of IOUS for detection of CBD stone was 100%, and 94.4% respectively in comparison to 100% sensitivity and specificity in the IOC. Conclusion: During the exploration of the CBD stones, the IOUS is just as sensitive and specific as the IOC. It's less invasive than IOC and can be done quickly by any skilled surgeon, so during a laparoscopic cholecystectomy, IOUS can reliably replace IOC.","PeriodicalId":53130,"journal":{"name":"International Journal of Medical Arts","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A Comparative Study between Operative Ultrasonography and Perioperative Cholangiography in Screening of The Common Bile Duct for Stones During Laparoscopic Cholecystectomy\",\"authors\":\"Ahmed Abdelhakim, Alsayed Hamdy, Ahmed Ahmed, Ahmed Abo Elfottoh\",\"doi\":\"10.21608/ijma.2023.236794.1815\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Article information Background: The routine uses of intraoperative cholangiography [IOC] is still controversial. Some authors support routine IOC, while others favor selective IOC. The operative ultrasonography [OUS] probe provides a new modality for evaluating biliary anatomy and detection of Choledocholithiasis during laparoscopic cholecystectomy. It is considered a faster, safer, and non-invasive technique. Aim of the Study: This study aims to compare the accuracy of operative ultrasonography [OUS] and IOC in the detection of common bile duct stones during laparoscopic cholecystectomy. Patients and Methods: This prospective comparative study included 50 patients who underwent laparoscopic cholecystectomies with or without bile duct exploration, which was done at El-Hussein University Hospital in the period from March 2018 to December 2019. Operative laparoscopic ultrasonography was performed followed by an operative cholangiogram. Bile ducts were explored if CBD stones were seen and the patients were followed up by clinical evaluation, laboratory investigations, and abdominal ultrasound within one month from surgery. Results: The IOUS timing which was the time after identification of the cystic duct and artery till the start of IOC, was significantly lower than the IOC Timing which was the time After IOUS till clipping of the proximal part of the cystic duct. The sensitivity and specificity of IOUS for detection of CBD stone was 100%, and 94.4% respectively in comparison to 100% sensitivity and specificity in the IOC. Conclusion: During the exploration of the CBD stones, the IOUS is just as sensitive and specific as the IOC. It's less invasive than IOC and can be done quickly by any skilled surgeon, so during a laparoscopic cholecystectomy, IOUS can reliably replace IOC.\",\"PeriodicalId\":53130,\"journal\":{\"name\":\"International Journal of Medical Arts\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Medical Arts\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.21608/ijma.2023.236794.1815\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Medical Arts","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.21608/ijma.2023.236794.1815","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
文章信息 背景:术中胆管造影术(IOC)的常规应用仍存在争议。一些学者支持常规术中胆管造影,而另一些学者则支持选择性术中胆管造影。术中超声探头(OUS)为腹腔镜胆囊切除术中评估胆道解剖结构和检测胆总管结石提供了一种新的模式。它被认为是一种更快、更安全、无创的技术。研究目的:本研究旨在比较腹腔镜胆囊切除术中手术超声波检查[OUS]和 IOC 检测胆总管结石的准确性。患者和方法:这项前瞻性比较研究纳入了 2018 年 3 月至 2019 年 12 月期间在侯赛因大学医院接受腹腔镜胆囊切除术并进行或不进行胆管探查的 50 名患者。在进行手术腹腔镜超声检查后,再进行手术胆管造影。如果看到CBD结石,则对胆管进行探查,并在手术后一个月内通过临床评估、实验室检查和腹部超声对患者进行随访。结果IOUS 时间是指确定胆囊管和胆囊动脉后到开始 IOC 的时间,明显低于 IOC 时间,后者是指 IOUS 后到剪断胆囊管近端部分的时间。IOUS检测CBD结石的敏感性和特异性分别为100%和94.4%,而IOC的敏感性和特异性均为100%。结论:在CBD结石的探查过程中,IOUS与IOC具有同样的敏感性和特异性。与 IOC 相比,IOUS 的创伤更小,任何熟练的外科医生都能快速完成,因此在腹腔镜胆囊切除术中,IOUS 可以可靠地取代 IOC。
A Comparative Study between Operative Ultrasonography and Perioperative Cholangiography in Screening of The Common Bile Duct for Stones During Laparoscopic Cholecystectomy
Article information Background: The routine uses of intraoperative cholangiography [IOC] is still controversial. Some authors support routine IOC, while others favor selective IOC. The operative ultrasonography [OUS] probe provides a new modality for evaluating biliary anatomy and detection of Choledocholithiasis during laparoscopic cholecystectomy. It is considered a faster, safer, and non-invasive technique. Aim of the Study: This study aims to compare the accuracy of operative ultrasonography [OUS] and IOC in the detection of common bile duct stones during laparoscopic cholecystectomy. Patients and Methods: This prospective comparative study included 50 patients who underwent laparoscopic cholecystectomies with or without bile duct exploration, which was done at El-Hussein University Hospital in the period from March 2018 to December 2019. Operative laparoscopic ultrasonography was performed followed by an operative cholangiogram. Bile ducts were explored if CBD stones were seen and the patients were followed up by clinical evaluation, laboratory investigations, and abdominal ultrasound within one month from surgery. Results: The IOUS timing which was the time after identification of the cystic duct and artery till the start of IOC, was significantly lower than the IOC Timing which was the time After IOUS till clipping of the proximal part of the cystic duct. The sensitivity and specificity of IOUS for detection of CBD stone was 100%, and 94.4% respectively in comparison to 100% sensitivity and specificity in the IOC. Conclusion: During the exploration of the CBD stones, the IOUS is just as sensitive and specific as the IOC. It's less invasive than IOC and can be done quickly by any skilled surgeon, so during a laparoscopic cholecystectomy, IOUS can reliably replace IOC.