Intraoperative sonography during cholecystectomy for gallstones

The current study reports on the ease and results of intraoperative sonography in 131 patients operated upon for gallstones. Sonography was performed through a standard incision or a small incision, without duodenal mobilization and prior to systematic cholangiography. Sonography or cholangiography, or both, detected biliary duct stones in eight patients. The entire biliary tract was visualized by ultrasound in 123 patients. Sonography identified seven patients with stones in the major biliary ducts and overlooked only a single stone of the cystic duct. In contrast, intraoperative cholangiography failed to reveal stones in a right hepatic duct and led, in another instance, to unnecessary choledochotomy. During cholecystectomy for gallstones, sonography is a simple efficient technique providing good detection of biliary stones. It is the study of choice and cholangiography is required in only selected instances in which sonographic visualization is incomplete. There may be future value in sonographic applications for laparoscopic cholecystectomy.