Intraoperative ultrasound during laparoscopic cholecystectomy

Backgraund: for the purpose of navigation during laparoscopic cholecystectomy, intraoperative laparoscopic ultrasound (IUS, LUS) has been actively used. This technique is non-invasive, non-irradiating and can be performed repeatedly. LUS has high sensitivity and specificity of 93% and 96%, respectively, and is also characterized by the high quality of intraoperative diagnostics of choledocholithiasis in real time, the absence of invasiveness, short imaging time, the ability to repeat imaging at any stage of the operation, and the absence of ionizing radiation.Aims: improve the results of laparoscopic cholecystectomy using laparoscopic ultrasound.Materials and methods: a review of the results of 455 LUS performed during laparoscopic cholecystectomy for cholelithiasis and its complicated forms since 2013 is presented. Patients range in age from 28 to 75 years. Aloka Prosound 6 device and UST-5550 linear laparoscopic high-frequency ultrasound transducer were used to perform LUS, with a movable distal working area, the possibility of using color and pulse Doppler examination.Results: LUS allows you to assess the condition of gallbladder walls, its lumen, condition of nearby organs, to obtain information about the topographic anatomy of bile ducts, as well as the structure of walls and contents of the bile ducts. The study allows to prevent vascular injury around the Calo triangle, to assess the condition of the lymph nodes of hepatoduodenal ligament. By means of a LUZI, visualization of instruments inserted into the lumen of the bile ducts is possible, which allows you to perform an operational manual under control.Conclusions: in all cases, the ultrasound was performed without complications, and no contraindications to the study were revealed. The average study time was about 4 minutes. Ultrasound allows you to identify in real time the anatomical features of the structure of the biliary tract and blood supply of a particular patient, assess the condition of the lumen of the biliary tract, assess the condition of the walls of the gallbladder and bile ducts, and the surrounding tissues. The ability to visualize instruments in the lumen of the bile ducts, as well as calculi and sludge, allows simultaneous intervention to be performed under LUS control