LAPAROSCOPIC INTRACORPOREAL ULTRASOUND - AN ALTERNATIVE TO CHOLANGIOGRAPHY

The purpose of this study was to compare laparoscopic intracorporeal u ltrasound (LICU) examination of the biliary duct system with cholangio graphy for delineation of duct anatomy and determination of presence o r absence of ductal calculi. Thirty-one patients had LICU examination of the extrahepatic bile ducts after exposure of the gallbladder but p rior to dissection of the cystic duct. After LICU examination, cystic duct dissection and cholangiography were done. Evaluation of duct anat omy and decision for duct exploration were based on findings of both t ests. All patients had successful LICU examination and 30 had successf ul cholangiography. Duct size as determined by LICU corresponded preci sely with cholangiography. LICU provided useful anatomical information in two patients with aberrant anatomy and detected choledocholithiasi s in five, one of whom had a negative cholangiogram. LICU aids in deli neation of biliary duct anatomy and accurately determines presence or absence of duct calculi.