Department of General Surgery - Corazon Locsin Montelibano Memorial Regional Hospital
OBJECTIVE: The purpose of this study is to determine the accuracy of surgeon-performed intraoperative ultrasound in detecting biliary tract stones during open cholecystectomy in comparison to intraoperative cholangiogram.
METHOD: This is a prospective cohort study comparing intraoperative cholangiogram and intraoperative ultrasound in detecting biliary tract stones in patients who will undergo open cholecystectomy with intraoperative cholangiogram at CLMMRH within the period of February 2014 to September 2015.
RESULTS:There were a total of 72 subjects in the study, 2 patients (2.8%) had true-positive results. Zero (0%) had false-postive results, 70 (97.2%) had true-negative results and none had false-negative results. The two (2) patients in the study that had positive results for biliary tract stones on IOC, which is our reference standard, underwent common bile duct exploration with stone extraction. Intraoperative ultrasound is as sensitive and as specific as intraoperative cholangiogram in dectecting biliary tract stones with an accuracy rate of 100% in this study.
DISCUSSION: The high accuracy rate (100%), sensitivity rate (100%), and specificity rate (100%) suggest that intraoperative ultrasound can recognize accurately the absence or presence of stones in the biliary tract. Its additional advantages are lesser operative time, lesser exposure to anesthetic drugs, no radiation exposure, and can be performed multiple times during the course of the procedure for verification.
CONCLUSIONS: The researcher recommends that Intraoperative ultrasound is a safe and a valuable alternative to, and may replace intraoperative cholangiogram in the future in detecting biliary tract stones, provided that the operator is well-trained and competent in doing such a procedure.
KEYWORDS: Intraoperative Cholangiogram, Intraoperative ultrasound, Common bile duct stone