Laparoscopic ultrasonography as an alternative to intraoperative cholangiography during laparoscopic cholecystectomy

Table 1 Results of PubMed review

Author	Year	Type of study	Number of patients	Surgeon	Routine LUS use	Detailed anatomical description	CBDS report	Specific aims of the study other than LUS efficacy
Tranter	2001	PNR	367	Several	+	Poor	+
Biffl	2001	PNR	248	Several	+	No	+	CBDI
Halpin	2002	PNR	380	Single	+	Yes	+	Comparison with IOC
Catheline	2002	PNR	900	ni	+	No	+	Comparison with IOC
Tranter	2003	PNR	135	Several	+	No	+	Comparison with IOC, measurement of duct diameter
Onders	2005	PNR	105	Single	-	No	+
Perry	2007	PNR	236	Single	+	Poor	+	Comparison with IOC
Machi	2007	PNR	200	Several	+	Poor	+	Cost
Hakamada	2008	RSS	299	Several	1	Yes	+	Educational program
Machi	2009	RMS	1352	Several	+	No	+
Hublet	2009	PNR	269	Single	+	Poor	+
Li	2009	PRN	103	Several	+	Yes	+
Hashimoto	2010	RMS	220	Several	+	Yes2	-	CBDI
Pfluke	2011	RSS	50	Several	+	Yes	+
Nasu	2012	PNR	71	ni	+	Poor	+
Kothari	2013	PNR	253	Several	+	Poor	-	Comparison with trans-abdominal US in obese patients
Gwinn	2013	PNR	44	Several	+	Poor	-	Impact of inflammatory disease
Shaaban	2014	RSS	70	Single	-	No	+
Meta-analysis
Aziz	2014	MA
Jamal	2015	MA

¹Since instigation as part of an educational program ;

²Focus on cystic duct-CBD junction. RSS: Retrospective single center study; RMS: Retrospective multicenter study; PNR: Prospective non-randomized study; MA: Meta-analysis; ni: No information; CBDS: Common bile duct stones; LUS: Laparoscopic ultrasound; IOC: Intraoperative cholangiography.

Table 2 laparoscopic ultrasound performed pre- or post- dissection

Author	Year	No. of patients	LUS pre-dissection	LUS post-dissection
Tranter	2001	367	-	+
Biffl	2001	248	+	+
Catheline	2002	900	+	-
Halpin	2002	380	-	+
Tranter	2003	135	-	+
Onders	2005	105	+	-
Machi	2007	200	+	+
Perry	2007	236	+	+	According to the situation
Hakamada	2008	299	+	+/-	After if necessary
Hublet	2009	269	-	+
Li	2009	103	+	-
Machi	2009	1352	+	+/-	After if necessary
Hashimoto	2010	220	+	+
Pfluke	2011	50	-	+
Nasu	2012	71	-	+
Gwinn	2013	44	+	-
Kothari	2013	253	+	-
Shaaban	2014	70	-	+

LUS: Laparoscopic ultrasound.

Table 3 Identification of biliary anatomy and variations

Author	Year	No. of Patients	Complete observation	Intrahepatic BD	Bifurcation	CHD	CBD	CD-CBD junction	Intra-pancreatic BD	Vascular visualization	Biliary anomalies	Foreshortened cystic duct (< 1 cm)	Abnormal cystic duct anatomy	Aberrant vascular anatomy
Tranter	2001	367	92%			92%	99%
Halpin	2002	380	90%				95%		94%
Tranter	2003	135	97.7%
Machi	2007	200	96.5%
Perry	2007	236	95.3%				98.5%							6.40%
Hakamada	2008	299	100%	100%1	88.6%-97.1%2		88.6%-99.4%2	91.4%-100%2	88.6%-98.3%2	89.3%-100%2
Hublet	2009	269	99%
Li	2009	103		95.7%		98.9	98.9%		73.8%
Machi	2009	1352	98%
Hashimoto	2010	200	-					94%3
Pfluke	2011	50	96%	100%			100%	98%	98%		40%	14%	8%	16%4
Gwinn	2013	44	100%

¹Not influenced by inflammation;

²Influenced by inflammation;

³Junction not identified when CBD < 5 mm;

⁴Accessory RHA (right hepatic artery) 8%, replaced RHA 6%, anterior cystic artery 2%. CHD: Common hepatic duct; CBD: Common bile duct.

Table 4 Reports of laparoscopic ultrasound used during acute or chronic cholecystitis

Author	Year	No. of patients	Inflammatory disease %	Comments
Biffl	2001	248	37.5
Catheline	2002	900	28.2
Onders	2005	105	6.3
Machi	2007	200	28.5
Perry	2007	236	5.5	LUS considered extremely valuable in 5.5%
Hakamada	2008	299	66.3	13.4% with severe inflammatory disease during 2nd period of study
Machi	2009	1352	20.9	LUS considered extremely valuable in 5.9%
Pfluke	2011	50	66.0
Gwinn	2013	44	100.0

LUS: Laparoscopic ultrasound.

Table 5 Common bile duct stones identification

Author	Year	No. of patients	Sensitivity %	Specificity %	Criteria to evaluate CBS LUS accuracy
					IOC	ERCP/surgical exploration	Follow-up
Tranter	2001	367	92	100	Selective	+	+
Biffl	2001	248	100	96.23	ni
Halpin	2002	380	97.5	100	Selective	+	+
Catheline	2002	900	80	99	Systematic
Tranter	2003	135	96	100	Systematic
Onders	2005	105	100	100	Selective	+
Perry	2007	236	92.3	100	Selective	+
Machi	2007	200	95	100	Selective	+	+
Hakamada	2008	299	76	99	Selective
Machi	2009	1352	98.6	99.58	1	+
Hublet	2009	269	100	99.6	Selective		+
Li	2009	103	82.1	98.7	Selective	+	+
Pfluke	2011	50	100	100	Selective
Nasu	2012	71	100	96.2	Selective
Shaaban	2014	70	92.3	98.2	No	+	+

¹Selective or systematic, according to center. ni: No information; LUS: Laparoscopic ultrasound; IOC: Intraoperative cholangiography; ERCP: Endoscopic retrograde cholangiopancreatography.

Table 6 Incidental findings

Author	Year	No. of patients examined using LUS	Incidental findings
Machi	2007	200	Cystic or solid tumors of the liver or pancreas in 31 patients; 14 biopsies and aspirations, 6 radiofrequency ablations
Perry	2007	236	Atrophic/hypertrophic or rotational anomalies or the liver, Mirizzi syndrome, vascular anomalies
Hakamada	2008	299	Polyps
Hublet	2009	269	1 hemobilia, 1 pancreatic pseudocyst, 1 IPMT, 1 pancreas divisum, 1 micro-calcification of the pancreatic head, 1 liver abscess, 1 liver tumor
Machi	2009	1352	Atrophic/hypertrophic or rotational anomalies or the liver, Mirizzi syndrome, vascular anomalies
Gwinn	2013	44	2 hepatic rotation anomalies
Kothari	2013	253	Polyps. Improved visualization of gallbladder walls in obese patient compared to trans-abdominal US

LUS: Laparoscopic ultrasound.