Radiology, Vol 185, 493-496, Copyright © 1992 by Radiological Society of North America
Intraoperative bile duct sonography during laparoscopic cholecystectomy: experience with a 12.5-MHz catheter-based US probe
SM Ascher, SR Evans, JA Goldberg, BS Garra, SB Benjamin, WJ Davros and RK Zeman
Department of Radiology, Georgetown University Hospital, Washington, DC 20007.
During elective laparoscopic cholecystectomy, 20 patients underwent
intraoperative evaluation of the biliary tract with a commercial 6.2-F,
12.5-MHz catheter-based ultrasound (US) probe. The study tested the
feasibility of this technology for mapping the anatomy of the
hepatoduodenal ligament and Calot triangle, assessing bile duct integrity,
and detecting choledocholithiasis. The duct was studied with a transmural
approach, the catheter being placed parallel to, but remaining outside, the
bile duct. The common hepatic duct and common bile duct in the vicinity of
the cystic duct were seen in all 20 patients; the junction of the cystic
duct with the common hepatic duct was seen in nine patients (45%). After
the cystic duct was clamped, no sonographic evidence to suggest bile duct
injury was noted in any patient. The transmural imaging approach was tested
in four pigs in whose common bile duct a single human calculus had been
placed. In all instances the size and location of the calculus were
accurately detected. Intraoperative US with a catheter-based system is a
safe and effective means for interrogation of the extrahepatic biliary tree
during laparoscopic cholecystectomy.
