我们旨在研究腹腔镜胆囊切除术中腹腔镜超声检查(LUS)替代术中胆道造影(IOC)的潜力,重点是与这两种技术相关的各个方面。我们通过PubMed搜索,WebofScience,科克伦图书馆,还有Scopus,使用以下搜索策略:(“腹腔镜超声检查”或LUS或“腹腔镜US”或“腹腔镜超声”)和(“腹腔镜胆囊切除术”或LC)。我们结合了针对我们主题的各种研究,提供有关胆道解剖结构和变异识别的数据,腹腔镜超声在胆囊炎中的应用,胆总管结石的检测,以及用于评估LUS准确性的标准。共筛选了1526篇文章,最终只纳入了20篇。本系统评价了LUS和IOC技术在胆囊切除术中的应用。IOC显示出较高的故障率,由于普通导管导管插入的挑战,虽然LUS的故障率较低,通常与脂肪变性等因素有关。成本效益比较有利于LUS而不是IOC,有可能为病人省钱。由于实时成像,LUS程序更快,国际奥委会需要更多的时间和人员。讨论了胆管损伤,突出了LUS在非典型解剖结构中的局限性。LUS帮助诊断关键情况,强调其术后相关性。外科医生的经验显着影响结果,不管技术。之前的一项研究讨论过,LUS的学习曲线比国际奥委会的学习曲线更陡,熟练的LUS用户调整实践并有选择地使用IOC。强调LUS在胆囊切除术中的益处和局限性,我们在复杂的解剖情况下强调它的价值。LUS证实没有胆总管结石,避免插管。LUS和IOC平等地检测胆总管结石并可视化胆道树。LUS提供安全性,速度,成本效益,无限使用。尽管相关的费用和学习曲线,在LUS成像中使用先进探针的持久优势表明,它可以超越传统的IOC.这种潜在进步的验证在很大程度上依赖于结合现代探针研究。我们的研究可以通过评估其临床有效性来为医学文献做出贡献,安全,成本效益,学习曲线,患者结果,技术进步,以及对临床专业人员指南和建议的潜在影响。
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.