The aim of this study was to evaluate ultrasonic findings as predictor of potential operative difficulties and complications during laparoscopic cholecystectomy (LC). From Auguest 1995 to December 1996 a total of 328 patients with symptomatic cholelithiasis (92 males, 236 females, mean age 45±17 years) were examined by ultrasonography (US) 1 to 3 days before LC. The US examination assessed six paramenters: (GB) volume of gallbladder thichness of GB wal position of neck of GB, stone mobility, maximal size of stone, and GB adhesions. On the basis of these US findings, a predictive judgment of technical difficulties was expressed as easy, difficult, and very difficult. Two hundred and twenty five patients presented with uncomplicated symptomatic cholelithiasis, and 103 had acute cholecystitis. The operation was predicted to be easy in 38% of cases, difficult in 48% and very difficult in 14% with a good correlation with the surgeon’s intraoperative judgment (Ｐ＜0.01). A significant association was found between stone mobility (Ｐ＜0.01), presence of adhesions (Ｐ＜0.01) and the difficulty of the procedure. Our results suggest that preoperative US is a useful screening test for patients undergoing LC, and it can help predict technical difficulties during LC.
Citation：
Lan Zhu,Wei Changzheng,Tian Ni.. THE VALUE OF PREOPERATIVE ULTRASONOGRAPHY FOR PREDICTING TECHNICAL DIFFICULTIES AND COMPLICATIONS DURING LAPAROSCOPIC CHOLECYSTECTOMY. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 1998, 5(2): 93-94. doi:
Copy
| 1. |
Dodds W, Groh W, Darweesh R. Sonographic measurement of gallbladder volume. AJR, 1985; 145(4)∶1009.
|
| 2. |
Bersi G, Sackier JM, Pazpartlow M. Routine or selected intraoperative cholangiography during laparoscopic cholecystectomy. Am J Surg, 1991; 161(3)∶355.
|
| 3. |
Brodish RJ, Fink AS. ERCP cholangiography and laparoscopic cholecystectomy: the society of american gastrointestinal endoscopic surgeons (SAGES) opinion survery. Surg Endosc, 1993; 7(1)∶3.
|
| 4. |
Carmody E, Arenson AM, Hanna S. Failed or difficult laparoscopic cholecystecotmy: can preoperative ultrasonography identify potential problems? J Clin Ultrasound, 1994; 22(6)∶391.
|
| 5. |
Fried G, Barkun JS, Sigman HH, et al. Factors determining conversion to laparotomy in patients undergoing lapatoscopic cholecystectomy. Am J Surg, 1994; 167(1)∶35.
|
- 1. Dodds W, Groh W, Darweesh R. Sonographic measurement of gallbladder volume. AJR, 1985; 145(4)∶1009.
- 2. Bersi G, Sackier JM, Pazpartlow M. Routine or selected intraoperative cholangiography during laparoscopic cholecystectomy. Am J Surg, 1991; 161(3)∶355.
- 3. Brodish RJ, Fink AS. ERCP cholangiography and laparoscopic cholecystectomy: the society of american gastrointestinal endoscopic surgeons (SAGES) opinion survery. Surg Endosc, 1993; 7(1)∶3.
- 4. Carmody E, Arenson AM, Hanna S. Failed or difficult laparoscopic cholecystecotmy: can preoperative ultrasonography identify potential problems? J Clin Ultrasound, 1994; 22(6)∶391.
- 5. Fried G, Barkun JS, Sigman HH, et al. Factors determining conversion to laparotomy in patients undergoing lapatoscopic cholecystectomy. Am J Surg, 1994; 167(1)∶35.
