Intraoperative ultrasonography for reducing bile duct injury during laparoscopic cholecystectomy.

Background/Aims: Laparoscopic cholecystectomy has become a standard procedure for gallstone disease. Bile duct injury during laparoscopic cholecystectomy is one of the most serious complications. The cause of such injury is usually the erroneous interpretation of bile duct anatomy, especially mistaking common bile duct for the cystic duct. A method for the prevention of this injury has not been established. The objective of this study was to test the usefulness of intraoperative ultrasonography for preventing bile duct injury. Methodology: We performed intraoperative ultrasonography to visualize the junction of the cystic duct and common bile duct before cannulation for intraoperative cholangiography. A total of 200 patients were enrolled in this study from May 2004 to November 2005. Results: In 188 out of 200 cases (94%), the junction was identified by intraoperative ultrasonography before the cholangiography. Conclusion: Identification of the junction of the cystic duct and common bile duct before intraoperative cholangiography may reduce bile duct injury in laparoscopic cholecystectomy.