Researchers from France and Australia determined whether laparoscopic ultrasonography complements cholangiography in the detection of choledocholithiasis at laparoscopic cholecystectomy.
The biliary trees of 900 patients undergoing laparoscopic cholecystectomy were examined routinely by laparoscopic ultrasonography and intraoperative cholangiography.
The diagnostic power of each investigation and of the 2 techniques in combination was evaluated.
The statistical non-random concordance between the 2 methods was also determined.
Laparoscopic ultrasonography was performed in all 900 patients, whereas cholangiography was performed in 85%.
| British Journal of Surgery |
The mean duration was 9·8 min for laparoscopic ultrasonography and 17·6 min for cholangiography.
For the detection of common bile duct stones, the non-random concordance between the 2 methods was considered to be fair to good.
The authors discovered that the sensitivity of laparoscopic ultrasonography was 0·80 and its specificity was 0·99.
The respective values for cholangiography were 0·75 and 0·99.
It was found that the examinations combined had a sensitivity of 0·95 and a specificity of 0·98.
Dr J. M. Catheline, of the Cairns Base Hospital, Cairns, Queensland, Australia, concluded on behalf of fellow colleagues, "Laparoscopic ultrasonography and intraoperative cholangiography are complementary, as the combination of both methods maximizes the intraoperative detection of choledocholithiasis."