Parasites and Biliary stones

Choledocholithiasis ٧٩
Operator dependency limits the usefulness of this modality. More
recently intraoperative ultrasonography of the CBD during laparoscopic
cholecystectomy has been shown to satisfactorily demonstrate stones and
the biliarys tree. Use of intraoperative ultrasound requires a significant
learning curves, but in experienced hands takes less operative time
(Cathelin et al., 2002 and Halpin et al., 2002).
Laparoscopic intracorporeal ultrasound is performed at the time of
laparoscopic cholecystectomy, and it is faster and more sensitive than
cholangiography. The benefits of this procedure include avoidance of
both cystic duct cannulation and ionizing radiation exposure (Juttijudata
et al., 1983 and Halpin, and Soper, 2001).
Postoperative studies: T-tube cholangiography, retained CBD stones are
identified in 2-10% of patients after CBD exploration. These are most
commonly detected upon routine T-tube cholangiography performed 7-10
days postoperatively. Also, ERCP and PTC are used as post operative
studies (Dandan, 2005).