A COMPARISON OF INTRAOPERATIVE ULTRASOUND VERSUS CHOLANGIOGRAPHY IN THE EVALUATION OF THE COMMON BILE-DUCT DURING LAPAROSCOPIC CHOLECYSTECTOMY

Indications for intraoperative evaluation of the common bile duct duri ng laparoscopic cholecystectomy are controversial, as is the goal of e ither anatomic definition or assessing for choledocholithiasis. One hu ndred twenty-five consecutive patients undergoing laparoscopic cholecy stectomy underwent both intraoperative ultrasound and intraoperative c holangiography. Cholangiography required slightly more time to perform ; it was more sensitive (92.8% vs 71.4%) but less specific (76.2% vs 1 00%) for choledocholithiasis than was ultrasound. Ultrasound was somew hat more difficult to perform, and, particularly in the setting of int raabdominal obesity, was often inadequate at providing clear visualiza tion of the intrapancreatic common bile duct. It did not provide the s ame anatomic definition as an adequate cholangiogram. The overall inci dence of choledocholithiasis was 11.2%.