ArticleAnnals of the Royal College of Surgeons of England2020
Cost effectiveness of intraoperative laparoscopic ultrasound for suspected choledocholithiasis; outcomes from a specialist benign upper gastrointestinal unit.
Article in Annals of the Royal College of Surgeons of England, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 19 citations in OpenAlex.
- Clinical outcomes of laparoscopic ultrasonography-guided emergency laparoscopic cholecystectomy in severe calculous cholecystitis: a comparative study.Surgical endoscopy · 2026Article
- High volume, quick turnover day-case robotic cholecystectomy utilising the HIT principle: a service evaluation for driving increased productivity.Journal of robotic surgery · 2025Article
- Management of common bile duct stones: a comprehensive review.Frontiers in surgery · 2025Review
- Reclaim the duct! Laparoscopic common bile duct exploration for the acute care surgeon.Trauma surgery & acute care open · 2025Review
- Intraoperative laparoscopic ultrasound during laparoscopic myomectomy: a narrative review.Journal of the Turkish German Gynecological Association · 2024Article
- A Systematic Review of Laparoscopic Ultrasonography During Laparoscopic Cholecystectomy.Cureus · 2023Review
- Clinical observation of laparoscopic cholecystectomy combined with endoscopic retrograde cholangiopancreatography or common bile duct lithotripsy.World journal of clinical cases · 2022Article
- Application of imaging techniques in pancreaticobiliary maljunction.World journal of clinical cases · 2022Review
- Safety, quality and efficiency of intra-operative imaging for treatment decisions in patients with suspected choledocholithiasis without pre-operative magnetic resonance cholangiopancreatography.Surgical endoscopy · 2022Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionCommon bile duct stones are present in 10% of patients with symptomatic gallstones. One-third of UK patients undergoing cholecystectomy will have preoperative ductal imaging, commonly with magnetic resonance cholangiopancreatography. Intraoperative laparoscopic ultrasound is a valid alternative but is not widely used. The primary aim of this study was to assess cost effectiveness of laparoscopic ultrasound compared with magnetic resonance cholangiopancreatography. MATERIALS AND
methodsA prospective database of all patients undergoing laparoscopic cholecystectomy between 2015 and 2018 at a district general hospital was assessed. Inclusion criteria were all patients, emergency and elective, with symptomatic gallstones and suspicion of common bile duct stones (derangement of liver function tests with or without dilated common bile duct on preoperative ultrasound, or history of pancreatitis). Patients with known common bile duct stones (magnetic resonance cholangiopancreatography or failed endoscopic retrograde cholangiogram) were excluded. Ninety-day morbidity data were also collected.
resultsA total of 420 (334 elective and 86 emergency) patients were suspected to have common bile duct stones and were included in the study. The cost of a laparoscopic ultrasound was £183 per use. The cost of using the magnetic resonance cholangiopancreatography unit was £365 per use. Ten postoperative magnetic resonance cholangiopancreatographies were performed for inconclusive intraoperative imaging. The estimated cost saving was £74,650. Some 128 patients had common bile duct stones detected intraoperatively and treated. There was a false positive rate of 4.7%, and the false negative rate at 90 days was 0.7%. laparoscopic ultrasound use saved 129 bed days for emergency patients and 240 magnetic resonance cholangiopancreatography hours of magnetic resonance imaging.
conclusionThe use of laparoscopic ultrasound during laparoscopic cholecystectomy for the detection of common bile duct stone is safe, accurate and cost effective. Equipment and maintenance costs are quickly offset and hospital bed days can be saved with its use.
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