The Application Of Laparoscopic Ultrasound In Cholecystectomy With Common Bile Duct Exploration

Objective To analyze the application value of laparoscopic ultrasound in cholecystectomy with common bile duct exploration.Methods 25 cases of gallstones were suspected with choledocholithiasis,showing abnormal liver function and thickening of common bile duct preoperative.All cases were planned for laparoscopic cholecystectomy with common bile duct exploration.Preoperative improve ultrasound and CT examination,if ultrasound and CT did not found common bile duct stones,magnetic resonance cholangiopancreatography was added.In all 25 cases,laparoscopic ultrasound was performed routinely in the operation,and the diagnosis of biliary calculi diseases postoperative was used as the gold standard.Results The postoperative diagnosis of 24 cases in 25 cases was gallbladder stones combined with choledocholithiasis,1 was gallbladder stones simply.Compared with the sensitivity of diagnosing choledocholithiasis,the difference between laparoscopic ultrasound and ultrasound was statistically significant(P < 0.05),but there was no significant difference compared with CT and laparoscopic ultrasound(P > 0.05).Choledocholithiasis was successfully diagnosed in 24 cases by laparoscopic ultrasound,and the bile duct and hepatic duct was imaged successfully in all cases.12 cases of difficult cholecystectomy due to serious adhesion were faced in the operations,10 of the 12 cases were operated in laparoscope with the assistance of laparoscopic ultrasound,2 cases were converted to open surgery after the scanning of laparoscopic ultrasound.Choledocholithiasis was not found in 1 case,and laparoscopic cholecystectomy was performed simply.All patients were followed up for 2 to 6 months postoperation.No patients were re-admitted due to biliary leakage,acute pancreatitis,acute cholangitis,biliary stricture,obstructive jaundice.Conclusion 1 The sensitivity of laparoscopic ultrasound in the diagnosis of choledocholithiasis is higher than that of trans-abdominal ultrasound,but the contrast with CT and magnetic resonance cholangiopancreatography needs to be confirmed by further study.2 In laparoscopic cholecystectomy with common bile duct exploration,laparoscopic ultrasound can help to understand the biliary tract shape and prevent biliary duct injury,and it plays a role in choosing a more reasonable surgical methods.