The role of preoperative B-mode and Doppler ultrasonography in predicting technical challenges for laparoscopic cholecystectomy.

PURPOSE The aim of this study was to predict probable technical challenges before laparoscopic cholecystectomy and to operate the proper patient at the right time and by the right technique. METHODS The study was performed in a tertiary reference hospital in six months. B-mod grey scale, colour, and power Doppler ultrasonographies were obtained for fifty consecutive patients for whom elective laparoscopic holecystectomies were planned. The technical difficulties were noted by a single surgeon observer while the teams were performing the operations. Neither the observer nor the members of the surgical team were aware of the preoperative test results. These two groups of parameters were compared. RESULTS There were significant correlations between the technical challenges encountered during the operations and preoperative ultrasonographic measurements: the mean of gallbladder wall thickness, increasing power Doppler signal of the gallbladder wall, stone size and the gallbladder's stone loading pattern. CONCLUSION B-mod grey scale and Doppler ultrasonography are the best tests at hand for predicting intraoperative challenges before laparoscopic surgery. It is important that the radiologist and surgeon reach consensus.

[1]  H. Bonjer,et al.  Can sonographic signs predict conversion of laparoscopic to open cholecystectomy? , 1998, Surgical Endoscopy.

[2]  A. Shrestha,et al.  Evaluation of predictive factors for conversion of laparoscopic cholecystectomy. , 2009, Kathmandu University medical journal.

[3]  J. Majeski.  Significance of Preoperative Ultrasound Measurement of Gallbladder Wall Thickness , 2007, The American surgeon.

[4]  S. Sharma,et al.  Predicting difficulties during laparoscopic cholecystectomy by preoperative ultrasound. , 2007, Kathmandu University medical journal.

[5]  S. Kawasaki,et al.  Conversion of elective laparoscopic to open cholecystectomy between 1993 and 2004 , 2006, The British journal of surgery.

[6]  V. Minutolo,et al.  Laparoscopic cholecystectomy (LC): predictive role of preoperative ultrasounds. , 2005, Il Giornale di chirurgia.

[7]  J. Nachnani,et al.  Pre-operative prediction of difficult laparoscopic cholecystectomy using clinical and ultrasonographic parameters. , 2005, Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology.

[8]  H. Chuang,et al.  Color Doppler Ultrasound Detection and Classification of the Tangential Hepatic Vein before Laparoscopic Cholecystectomy , 2005, Surgical Endoscopy And Other Interventional Techniques.

[9]  B. Kang,et al.  Evaluation of preoperative sonography in acute cholecystitis to predict technical difficulties during laparoscopic cholecystectomy , 2004, Journal of clinical ultrasound : JCU.

[10]  Iftikhar Khan,et al.  Laparoscopic cholecystectomy for acute cholecystitis. Can preoperative factors predict conversion? , 2004, Saudi medical journal.

[11]  R. Costi,et al.  Scoring system to predict asymptomatic choledocholithiasis before laparoscopic cholecystectomy , 2003, Surgical Endoscopy And Other Interventional Techniques.

[12]  A. Halefoglu,et al.  Role of preoperative color doppler ultrasound scan in the evaluation of the risk of injury of major branches of the middle hepatic vein during laparoscopic cholecystectomy. , 2002, International surgery.

[13]  R. Costi,et al.  Preoperative Ultrasonographic Assessment of the Number and Size of Gallbladder Stones , 2002, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[14]  V. Malik,et al.  A Difficult Laparoscopic Cholecystectomy That Requires Conversion to Open Procedure Can Be Predicted by Preoperative Ultrasonography , 2002, JSLS : Journal of the Society of Laparoendoscopic Surgeons.

[15]  M. Dolapci,et al.  Risk factors resulting in conversion of laparoscopic cholecystectomy to open surgery , 2001, Surgical Endoscopy.

[16]  B. Ammori,et al.  Elective laparoscopic cholecystectomy: preoperative prediction of duration of surgery. , 2001, Surgical endoscopy.

[17]  F. Calliada,et al.  Power Doppler ultrasound of gallbladder wall vascularization in inflammation: clinical implications , 2000, European Radiology.

[18]  M. Valle,et al.  Power Doppler sonography: clinical applications. , 1998, European journal of radiology.

[19]  S. Daradkeh,et al.  Preoperative Ultrasonography and Prediction of Technical Difficulties during Laparoscopic Cholecystectomy , 1998, World Journal of Surgery.

[20]  I. Braghetto,et al.  Correlation among ultrasonographic and videoscopic findings of the gallbladder: surgical difficulties and reasons for conversion during laparoscopic surgery. , 1997, Surgical laparoscopy & endoscopy.

[21]  C. Kum,et al.  Predictive Factors for Conversion of Laparoscopic Cholecystectomy , 1997, World Journal of Surgery.

[22]  J. Caplehorn,et al.  Preoperative ultrasound to predict conversion in laparoscopic cholecystectomy. , 1997, Surgical laparoscopy & endoscopy.

[23]  R. Jeffrey,et al.  Power versus color Doppler sonography of the normal cystic artery: implications for patients with acute cholecystitis. , 1997, AJR. American journal of roentgenology.

[24]  R. Santambrogio,et al.  Technical Difficulties and Complications during Laparoscopic Cholecystectomy: Predictive Use of Preoperative Ultrasonography , 1996, World Journal of Surgery.

[25]  S. Fan,et al.  Factors affecting conversion of laparoscopic cholecystectomy to open surgery. , 1996, Archives of surgery.

[26]  H. Tu,et al.  The value of ultrasound measurement of gallbladder wall thickness in predicting laparoscopic operability prior to cholecystectomy. , 1995, Clinical radiology.

[27]  C. Kum,et al.  Laparoscopic cholecystectomy for acute cholecystitis , 1994, The British journal of surgery.

[28]  A. Arenson,et al.  Failed or difficult laparoscopic cholecystectomy: Can preoperative ultrasonography identify potential problems? , 1994, Journal of clinical ultrasound : JCU.

[29]  W. Lau,et al.  Preoperative ultrasound to predict technical difficulties and complications of laparoscopic cholecystectomy. , 1994, American journal of surgery.

[30]  W. Brugge.  Motor function of the gallbladder: measurement and clinical significance. , 1991, Seminars in roentgenology.