[Intraoperative ultrasonography in laparoscopic cholecystectomy]

Laparoscopic ultrasonography has been increasingly used over the last several years as a new imaging modality. This study assessed the effectiveness of laparoscopic ultrasonography in detecting main biliary duct stones during laparoscopic cholecystectomy.

During the eight-year period 1991-98, 441 patients treated by laparoscopic cholecystectomy were at the same time included in laparoscopic ultrasonography. After port placement and dissection of the gallbladder, laparoscopic ultrasonography of the extrahepatic common bile duct was performed in the longitudinal plane.

Laparoscopic ultrasonography failed to recognise the intrapancreatic part of the common bile duct in 64 cases (14%). The time used for sonography was approximately eight minutes. In this study, common bile duct stones were found in 29 cases (7%). One false negative result was recognised.

Laparoscopic ultrasonography is a safe, repeatable, noninvasive and cost-effective procedure, but a considerable learning curve is necessary in order to optimise its efficacy. Once learned, however, the method can be used as a primary screening procedure for bile duct calculi.