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Awan B, Elsaigh M, Marzouk M, Sohail A, Elkomos BE, Asqalan A, Baqar SO, Elgndy N, Saleh O, Szul J, San Juan A, Alasmar M. A Systematic Review of Laparoscopic Ultrasonography During Laparoscopic Cholecystectomy. Cureus 2023; 15:e51192. [PMID: 38283459 PMCID: PMC10817818 DOI: 10.7759/cureus.51192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2023] [Indexed: 01/30/2024] Open
Abstract
We aim to investigate the potential of laparoscopic ultrasonography (LUS) as a replacement for intraoperative cholangiography (IOC) in the context of laparoscopic cholecystectomy focusing on various aspects related to both techniques. We made our search through PubMed, Web of Science, Cochrane Library, and Scopus, with the use of the following search strategy: ("laparoscopic ultrasonography" OR LUS OR "laparoscopic US" OR "laparoscopic ultrasound") AND ("laparoscopic cholecystectomy" OR LC). We incorporated diverse studies that addressed our topic, offering data on the identification of biliary anatomy and variations, the utilization of laparoscopic ultrasound in cholecystitis, the detection of common bile duct stones, and the criteria utilized to assess the accuracy of LUS. A total of 1526 articles were screened and only 20 were finally included. This systematic review assessed LUS and IOC techniques in cholecystectomy. IOC showed higher failure rates due to common duct catheterization challenges, while LUS had lower failure rates, often linked to factors like steatosis. Cost-effectiveness comparisons favored LUS over IOC, potentially saving patients money. LUS procedures were quicker due to real-time imaging, while IOC required more time and personnel. Bile duct injuries were discussed, highlighting LUS limitations in atypical anatomies. LUS aided in diagnosing crucial conditions, emphasizing its relevance post surgery. Surgeon experience significantly impacted outcomes, regardless of the technique. A previous study discussed that LUS's learning curve was steeper than IOC's, with proficient LUS users adjusting practices and using IOC selectively. Highlighting LUS's benefits and limitations in cholecystectomy, we stress its value in complex anatomical situations. LUS confirms no common bile duct stones, avoiding cannulation. LUS and IOC equally detect common bile duct stones and visualize the biliary tree. LUS offers safety, speed, cost-effectiveness, and unlimited use. Despite the associated expenses and learning curve, the enduring benefits of using advanced probes in LUS imaging suggest that it could surpass traditional IOC. The validation of this potential advancement relies heavily on incorporating modern probe studies. Our study could contribute to the medical literature by evaluating their clinical validity, safety, cost-effectiveness, learning curve, patient outcomes, technological advancements, and potential impact on guidelines and recommendations for clinical professionals.
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Affiliation(s)
- Bakhtawar Awan
- General and Emergency Surgery, Northwick Park Hospital, London, GBR
| | - Mohamed Elsaigh
- General and Emergency Surgery, Northwick Park Hospital, London, GBR
| | - Mohamed Marzouk
- General and Emergency Surgery, Northwick Park Hospital, London, GBR
| | - Azka Sohail
- General and Emergency Surgery, Northwick Park Hospital, London, GBR
| | | | - Ahmad Asqalan
- Thoracic Surgery, Norfolk and Norwich University Hospital, Norwich, GBR
| | - Safa O Baqar
- Colorectal Surgery, Derriford Hospital, University Hospitals Plymouth, Plymouth, GBR
| | - Noha Elgndy
- Acute and Emergency Medicine, Frimley Park Hospital, Surrey, GBR
| | - Omnia Saleh
- General and Gastrointestinal Surgery, Laboratory for Surgical and Metabolic Research, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Justyna Szul
- General and Emergency Surgery, Northwick Park Hospital, London, GBR
| | - Anna San Juan
- General and Emergency Surgery, Northwick Park Hospital, London, GBR
| | - Mohamed Alasmar
- General Surgery, Salford Royal Hospital, University of Manchester, Manchester, GBR
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Xu X, Guo D, Zhang Y, Yang D, Hou G, Li Q, Ge C, Qie Z, Zhong Y. Effect of Microscope Combined with Wechat Smart Platform on Clinical Efficacy and Gastrointestinal Function of Patients with Cholecystolithiasis Combined with Common Bile Duct Stones. SCANNING 2022; 2022:9661506. [PMID: 35832300 PMCID: PMC9262574 DOI: 10.1155/2022/9661506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 05/20/2022] [Accepted: 06/16/2022] [Indexed: 06/15/2023]
Abstract
To explore the clinical efficacy of microscope combined with Wechat smart platform in patients with cholecystolithiasis and choledocholithiasis, this paper proposes the effect of microscope combined with Wechat smart platform intervention after laparoscopic lithotomy and choledocholithotomy on the clinical efficacy and gastrointestinal function of patients with cholecystolithiasis combined with choledocholithiasis. From February 2018 to March 2019, 78 patients with gastric cancer were selected by our clinic and included in the research team. Evaluate the efficacy of endoscopic biliary lithotomy (LBL) + bile duct lithotomy (TBL) + T-tube drainage therapy to provide reliable evidence for improved efficacy and efficacy in order to provide a strong reference for improving the effectiveness and safety of surgical treatment of choledocholithiasis. Safety of surgical treatment of diseases. Gallstone disease. The experiments did not show any significant differences between the two groups during surgery. Diabetes was lower in the control group, and hospital incidence was lower in the control group. There were no significant differences between the two groups for preoperative WHOQOL-100 scores. Two weeks and four weeks after surgery, the man-key-100 score was higher than that of the control group. Endoscopic cholecystectomy + choledocholithotomy + choledochoscopic lithotomy + T-tube fluid have been shown to be effective in promoting rapid intestinal function and improving patient quality of life and are appropriate for therapeutic use.
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Affiliation(s)
- Xu Xu
- Department of Hepatobiliary Surgery, Second Hospital of Baoding, Baoding, Hebei 071051, China
| | - Dongmei Guo
- Department of Hepatobiliary Surgery, Second Hospital of Baoding, Baoding, Hebei 071051, China
| | - Yan Zhang
- Department of Hepatobiliary Surgery, Second Hospital of Baoding, Baoding, Hebei 071051, China
| | - Dandan Yang
- Department of Hepatobiliary Surgery, Second Hospital of Baoding, Baoding, Hebei 071051, China
| | - Guangbin Hou
- Department of Hepatobiliary Surgery, Second Hospital of Baoding, Baoding, Hebei 071051, China
| | - Quanfu Li
- Department of Hepatobiliary Surgery, Second Hospital of Baoding, Baoding, Hebei 071051, China
| | - Changqing Ge
- Department of Hepatobiliary Surgery, Second Hospital of Baoding, Baoding, Hebei 071051, China
| | - Zengwang Qie
- Department of Hepatobiliary Surgery, Second Hospital of Baoding, Baoding, Hebei 071051, China
| | - Yonggang Zhong
- Department of Hepatobiliary Surgery, Second Hospital of Baoding, Baoding, Hebei 071051, China
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Manatakis DK, Tasis N, Antonopoulou MI, Agalianos C, Piagkou M, Tsiaoussis J, Natsis K, Korkolis DP. Morphology of the sulcus of the caudate process (Rouviere's sulcus) in a Greek population and a systematic review with meta-analysis. Anat Sci Int 2021; 97:90-99. [PMID: 34542789 DOI: 10.1007/s12565-021-00628-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/05/2021] [Indexed: 01/06/2023]
Abstract
The purpose of this study was to determine the prevalence and to investigate the morphology of the sulcus of the caudate process in a Greek population, along with a systematic review and meta-analysis of the literature. Overall, 103 consecutive patients undergoing laparoscopic cholecystectomy were included in the analysis. The sulcus was present in 91% and three morphological variants were identified (groove 69%, slit 21% and scar 10%). The sulcus had a horizontal course in 90% of patients and a mean length of 25 ± 13 mm. The meta-analysis included 27 surgical and 11 cadaveric studies with 6661 cases in total. The pooled prevalence of the sulcus was 80% and did not differ significantly among various geographical regions. Concerning sulcus subtypes, the binary "open/fused" classification was used to unify the heterogeneous data. The "open" type was more frequent than the "fused" (64.5% vs 35.5%). A horizontal course was observed in 53.5% and an oblique in 45.7%. The sulcus contained the right portal pedicle in 38%, the right posterior portal pedicle in 37%, and the right posteroinferior pedicle in 23.5%. In conclusion, the sulcus of the caudate process is a very helpful anatomical landmark in hepatectomy and laparoscopic cholecystectomy and can be identified in the majority of patients. However, various classifications for the morphological variants and diverse terminology cause discrepancy in the literature and create the need for a single classification system. The proposed 3-tier classification (groove, slit, scar) is simple and easy to remember and avoids ambiguous nomenclature.
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Affiliation(s)
- Dimitrios K Manatakis
- Department of Surgery, Athens Naval and Veterans Hospital, Deinokratous 70, 11521, Athens, Greece.
| | - Nikolaos Tasis
- Department of Surgery, Athens Naval and Veterans Hospital, Deinokratous 70, 11521, Athens, Greece
| | | | - Christos Agalianos
- Department of Surgery, Athens Naval and Veterans Hospital, Deinokratous 70, 11521, Athens, Greece
| | - Maria Piagkou
- Department of Anatomy, Faculty of Health Sciences, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - John Tsiaoussis
- Laboratory of Anatomy, School of Medicine, University of Crete, Heraklion, Greece
| | - Konstantinos Natsis
- Department of Anatomy and Surgical Anatomy, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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