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A prospective comparison of laparoscopic ultrasound vs intraoperative cholangiogram during laparoscopic
R A Falcone1, E J Fegelman, M S Nussbaum
1College 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
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.