Comparaison de l'echolaparoscopie et de la cholangiographie lors des cholecystectomies laparoscopiques

Catheline, Jean-Marc, Capelluto, Elie, Turner, Richard, Rizk, Nabil, Barrat, Christophe, Cazacu, Florin, and Champault, Gerard (2000) Comparaison de l'echolaparoscopie et de la cholangiographie lors des cholecystectomies laparoscopiques. Gastroenterologie Clinique et Biologique, 24. pp. 619-625.

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Aim - Prospective evaluation of the results of laparoscopic ultrasound and cholangiography to investigate choledocholithiasis and detect variations in biliary anatomy during laparoscopic cholecystectomies.

Methods - The biliary trees of 600 patients who underwent laparoscopic cholecystectomy were routinely explored by laparoscopic ultrasound and cholangiography.

Results - Laparoscopic ultrasound was performed in all 600 cases. Cholangiography was perFormed in 498 (83%). Laparoscopic ultrasound required less time than cholangiography: 10.2 minutes versus 17. 9 minutes (p=0.0001). Common bile duct stones were detected intraoperatively in 40 cases (7%). Both methods were equally effective. The sensitivity of laparoscopic ultrasound was 80% and its specificity 99%. For cholangiography these values were 75% and 98%; respectively. For laparoscopic ultrasound, false positives and False negatives were noted in the First 45 cases of individual trainees. Nevertheless, cholangiography showed 30 anatomical anomalies and laparoscopic ultrasound only 15. Conclusion - Laparoscopic ultrasound can be performed rapidly and in all cases. Results are comparable to cholangiography in the detection of common duct stones. Individual training is necessary to optimize efficacy. Anatomical anomalies are often missed.

Item ID: 26250
Item Type: Article (Research - C1)
ISSN: 0399-8320
Keywords: laparoscopic cholecystectomy; laparoscopic ultrasound; intraoperative cholangiographry
Additional Information:

Title: Comparison of laparoscopic ultrasound and cholangiography during laparoscopic cholecystectomies. Results of a prospective study.

Abstract [French]: Objectifs - Comparaison, au cours d'une etude prospective, de I'echolaparoscopie et de la cholangiographie pour la mise en evidence d'une lithiase de la vaie biliaire principale et la detection d' anomalies de I'anatomie biliaire lors des cholecystectomies lapa-roscopiques. Methodes - Chez 600 malades consecutifs, cholecystectomises sous laparoscopie, I'operateur a tente de realiser systematiquement ces 2 methodes d'exploration des voies biliaires. Resultats - La faisabilite de I'echolaparoscopie a Me de 100%. La cholangiographie n' a pu etre effectuee que dans 498 cas (83%). La duree moyenne de I'echolaparoscopie a ete significativement plus courte que celie de la cholangiographie (10,2 versus 17,9 minutes, P =0,0001). Quarante cas de lithiase de la voie biliaire principale ont ete constates en per-operatoire (7% des malades). Les resultats des 2 methodes pour sa detection ont ete comparables. La sensibilite et la specificite de I'echolaparoscopie ont Me respectivement de 80% et de 99%, celles de la cholangiographie de 75% et de 98%. Pour I'echolaparoscopie, les faux negatifs et les faux positifs ont Me constates lors des 45 premieres explorations de chaque operateur. Par ailleurs, 30 anomalies de I'anatomie biliaire ont ete individuali-sees en cholangiographie centre seulement 15 en echolaparoscopie. Conclusion - L'echolaparoscopie est rapide a effectuer et peut toujours etre realisee. Elle est comparable a la cholangiographie pour la detection d'une lithiase de la voie biliaire principale. Une formation specifique est necessaire pour optimiser son efficacite. L'echolaparoscopie meconnait des anomalies de I'anatomie biliaire.

Date Deposited: 28 Apr 2013 22:31
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1113 Ophthalmology and Optometry > 111302 Optical Technology @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920118 Surgical Methods and Procedures @ 100%
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