THE VALUE OF SONOGRAPHY PRIOR TO LAPAROSC OPIC CHOLECYSTECTOMY

The increasing use of minimally invasive techniques for the treatment of symptomatic cholecystitis requires exact preoperative diagnosis. Th e significant sonographic findings are stones in the biliary system or indirect evidence of stones, consisting in dilatation of the bile duc t to more than 10 mm, as well as free mobility of the abdominal wall t o exclude peri-umbilical adhesions. Amongst 100 patients who had lapar oscopic cholecystectomies there were 7 with bile ducts wider than 10 m m. In two of these cases calculi could also be demonstrated. ERCP was performed on the remaining five and in 3 of these stones were seen. Pe ri-umbilical adhesions were seen in 6 Patients, resulting in alternati ve placing of the incision. The sonographic findings which are of rele vance to the surgeon were analysed in these 100 cases. A standardised examination protocol is an important feature for proper patient select ion.