Intraoperative ultrasonography (IOUS) during laparoscopic cholecystectomy

R. Santambrogio, P. Bianchi, E. Opocher, A. Mantovani, L. Schubert, F. Ghelma, M. Panzera, M. Verga, G. P. Spina

Research output: Contribution to journalArticlepeer-review


Background: The purpose of this study was to evaluate the usefulness of intraoperative ultrasonography (IOUS), a new method of imaging the biliary tree and related structures, during laparoscopic cholecystectomy. Method: An IOUS probe (Aloka, Tokyo, Japan) with a 7.5-MHz linear-array transducer was used during cholecystectomy in 124 patients with symptomatic cholelithiasis (45 men, 79 women; mean age, 48 ± 14 years). Results: The examination of the common bile duct (CBD) was excellent in 117 patients but unsatisfactory in 7 cases (5.6%) at the level of the head of the pancreas. In 5 patients, IOUS showed unsuspected choledocholithiasis: a subsequent intraoperational cholangiogram confirmed this. In five cases IOUS was able to help the surgeon to localize a Calot area obscured by inflammation. Postoperatively, one patient had an injury of the cystic duct stump: a nasobiliary tube resolved the bile leakage after 7 days. Another patient was submitted to postoperative endoscopic retrograde cholangiopancreatography (ERCP) for a choledocholithiasis recognized by a trans-cystic-tube cholangiography: the stone was suspected but not demonstrated either by laparoscopic IOUS or by intraoperative cholangiography. During the follow-up period, one patient had an episode of acute pancreatitis. ERCP showed a small stone wedged in the sphincter of Oddi. Conclusions: IOUS may be a real alternative to cholangiography during laparoscopic cholecystectomy since it is safer and offers a complete examination of the biliary tree. It has some disadvantages which can solved by additional experience.

Original languageEnglish
Pages (from-to)622-627
Number of pages6
JournalSurgical Endoscopy and Other Interventional Techniques
Issue number6
Publication statusPublished - 1996


  • Intraoperative cholangiogram
  • Intraoperative ultrasound
  • Laparoscopic cholecystectomy

ASJC Scopus subject areas

  • Surgery


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