Ecografia intraaperatoria laparoscopica. Modalita di esecuzione e note tecniche durante colecistectomia

The increasing use of laparoscopic cholecystectomy has raised the problem of intraoperative imaging of common bile duct stones. To this regard, both colangiography and ultrasound have been evaluated. The authors report their experience with laparoscopic ultrasonography. They describe the technical steps to perform an accurate ultrasound examination and report the results in 43 patients submitted to laparoscopic cholecystectomy. The ultrasound examination of the gallbladder showed a good correlation with pathological inflammatory findings (r = 0.62), diameter (r = 0.87) and number of stones (r = 0.93). In 2 cases, it showed unsuspected common bile duct stones, while in one case it was not able to detect a small stone located at the ampulla and discovered by an ERCP one month following the operation. They conclude that laparoscopic ultrasound allows an accurate visualization of biliary tree and could be used as a primary technique for evaluation of gallbladder, common bile duct, liver and pancreas during laparoscopic cholecystectomy.