Simple laparoscopic ultrasound technique for prevention of bile duct injuries

Background: Bile duct injuries are serious complications of laparoscopic ch olecystectomy, Laparoscopic ultrasonography (LUS) has been utilized over th e last several years to screen for bile duct calculi and to delineate bilia ry anatomy. We have found a simple LUS scanning technique that can be usefu l for preventing bile duct injuries. Method: After initial scanning for screening, laparoscopic dissection is co ntinued, isolating the cystic duct. If necessary, scanning can be performed to assure the location of the cystic duct before clipping. After clips are applied to the cystic duct, prior to its incision or transection, LUS is r epeated to examine the cystic and bile ducts. Results: This postclipping study can confirm that the clips are applied to the cystic duct and that the hepatic and common bile ducts are intact witho ut occlusion, Conclusion: This additional LUS scanning maneuver is simple and quick and m ay help prevent bile duct injuries.