Application of Laparoscopic Ultrasound in Cystic Duct Stone Surgery: A Retrospective Experience

Abstract

Objective

To investigate the value of laparoscopic ultrasound (LUS) in the diagnosis of cystic duct stones and formulation of surgical strategies.

Materials and Methods

Clinical data from 41 patients with cystic duct stones were retrospectively analyzed. LUS was used to evaluate stone distribution and assess the surrounding vasculature, thereby preventing residual stones. Additionally, LUS was used to detect concurrent common bile duct (CBD) stones or assess potential stone migration into the CBD.

Results

Thirty-nine patients underwent laparoscopic cholecystectomy (LC), and two patients underwent LC combined with CBD exploration. The mean postoperative hospital stay was 3.95 ± 1.02 days. During a 3-month to 1-year follow-up, no biliary complications occurred.

Conclusion

LUS ensures safe and effective cholecystectomy for cystic duct stones by enabling real-time stone detection and preventing residual or migrated stones.

Keywords

laparoscopic ultrasound - gallstones - cystic duct stones - laparoscope - laparoscopic cholecystectomy - intraoperative diagnosis - surgical strategy

• References

• 1 Cuschieri A. Laparoscopic cholecystectomy. J R Coll Surg Edinb 1999; 44 (03) 187-192
• 2 Alli VV, Yang J, Xu J. et al. Nineteen-year trends in incidence and indications for laparoscopic cholecystectomy: the NY State experience. Surg Endosc 2017; 31 (04) 1651-1658
• 3 Li Y, Zhang L, Hou S. Cystic duct stones in postcholecystectomy Mirizzi syndrome - a novel endoscopic treatment. Rev Esp Enferm Dig 2022; 114 (09) 557-558
• 4 Guoan X, Kaiyun C, Fanglian X. Laparoscopic cholecystectomy! For incarcerated cystic duct stones accompanying gallbladder empyema. Chinese Journal of Minimally Invasive Surgery 2006
• 5 Shaw C, O'Hanlon DM, Fenlon HM, McEntee GP. Cystic duct remnant and the ‘post-cholecystectomy syndrome.’. Hepatogastroenterology 2004; 51 (55) 36-38
• 6 Mahmud S, Hamza Y, Nassar AHM. The significance of cystic duct stones encountered during laparoscopic cholecystectomy. Surg Endosc 2001; 15 (05) 460-462
• 7 Hubert C, Annet L, van Beers BE, Gigot JF. The “inside approach of the gallbladder” is an alternative to the classic Calot's triangle dissection for a safe operation in severe cholecystitis. Surg Endosc 2010; 24 (10) 2626-2632
• 8 Doush W, Abdelaziz MS, Musaad AM. The surgical outcomes of fundus-first technique in lowering the rate of bile duct injuries and bleeding during open cholecystectomy that facing intraoperative difficulties: a single-center prospective study. AL-Kindy College. Med J (Ft Sam Houst, Tex) 2023;
• 9 Dexing C, Yiping M, Yiping Z. Management of stone impacted at cystic duct during laparoscopic cholecystectomy. Chinese J Minimal Invas Surg 2002; 6 (04) 407-408
• 10 Köckerling F, Schneider C, Reymond MA, Hohenberger W. [Extraction of cystic duct occlusion calculus in laparoscopic cholecystectomy]. Zentralbl Chir 1997; 122 (04) 295-298
• 11 Bezzi M, Silecchia G, De Leo A, Carbone I, Pepino D, Rossi P. Laparoscopic and intraoperative ultrasound. Eur J Radiol 1998; 27 (2, suppl 2): S207-S214
• 12 Jamal KN, Smith H, Ratnasingham K, Siddiqui MR, McLachlan G, Belgaumkar AP. Meta-analysis of the diagnostic accuracy of laparoscopic ultrasonography and intraoperative cholangiography in detection of common bile duct stones. Ann R Coll Surg Engl 2016; 98 (04) 244-249
• 13 Dili A, Bertrand C. Laparoscopic ultrasonography as an alternative to intraoperative cholangiography during laparoscopic cholecystectomy. World J Gastroenterol 2017; 23 (29) 5438-5450