ArticleBMC surgery2026
The convenience of contrast-enhanced intraoperative ultrasonic cholangiography in liver resection: a study protocol for a randomized, prospective, off-label trial.
Article in BMC surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundIntraoperative cholangiography (IOC) is widely used to delineate biliary anatomy and confirm ductal integrity during liver resection. However, conventional radiographic IOC requires a C-arm set-up, may interrupt the operative workflow, and exposes patients and operating-room personnel to ionizing radiation. Contrast-enhanced intraoperative ultrasonic cholangiography (CE-IOUSC) combines intrabiliary injection of highly diluted perfluorobutane microbubbles (Sonazoid
methodsThis is a single-center, open-label, randomized, parallel-group, phase III comparative trial. Adults (≥ 20 years) scheduled for liver resection, including living donors, are eligible when cholecystectomy and transcystic catheterization via the cystic duct are feasible. After informed consent, participants are randomized 1:1 (stratified by liver condition: normal vs. impaired) to CE-IOUSC or conventional radiographic IOC using a computer-generated sequence. In both arms, cholangiography is performed twice-before and after bile duct division-with additional imaging permitted as clinically required. Conventional IOC uses diluted iothalamate contrast (Urografin DISCUSSION: This trial will quantify whether CE-IOUSC improves the efficiency and usability of intraoperative biliary imaging without compromising visualization or patient safety. The results will inform evidence-based adoption of ultrasound-based cholangiography as a practical alternative to conventional radiographic IOC in liver resection.
trial registrationJapan Registry of Clinical Trials (jRCT), jRCTs051230202.
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