Home About us Contact
|
Home About us Contact | ||
|
|
||
GB Wall (gb + wall)
Selected AbstractsEvaluation of preoperative sonography in acute cholecystitis to predict technical difficulties during laparoscopic cholecystectomyJOURNAL OF CLINICAL ULTRASOUND, Issue 3 2004Kyung Soo Cho MD Abstract Purpose The aim of this study was to evaluate the role of preoperative sonography in predicting technical difficulties during laparoscopic cholecystectomy in patients with acute cholecystitis. Methods Sonographic assessment of 14 parameters was performed in 55 patients during a 9-month period: volume of gallbladder (GB), thickness of GB wall, pattern of GB wall thickening, size of largest gallstone, gallstone mobility, adhesion of GB to its bed, fat plane between GB and hepatoduodenal ligament, free fluid in GB fossa, common bile duct (CBD) dilatation, CBD stone(s), color and power Doppler signals in GB wall, and increased color and power Doppler signals in adjacent liver. Each of the 5 operative steps of laparoscopic cholecystectomy was scored as being difficult (1) or not (0). The scores for each step were added to obtain the overall difficulty score (0,5). We evaluated prospectively whether there were significant associations among the preoperative sonographic findings and the overall difficulty score, scores for each of the 5 operative steps, and operation time. Results The overall difficulty score was significantly associated with a GB volume of 50 cm3 or more, GB wall thickness of 3 mm or more, and presence of color Doppler signals in the GB wall. Increased GB volume also made dissection of adhesions from the GB and dissection of Calot's triangle more difficult. Extraction of the GB from the abdomen was more difficult with a thickened GB wall or adhesion of the GB to its bed. The presence of a CBD stone, dilatation of the CBD (, 8 mm), color Doppler signals in the GB wall, and increased power Doppler signals in the adjacent liver were significantly associated with increased operation time. Conclusions Based on our experience, preoperative determination of GB volume, GB wall thickness, and presence of color Doppler signals in the GB wall in patients with acute cholecystitis helps predict technical difficulties during laparoscopic cholecystectomy. © 2004 Wiley Periodicals, Inc. J Clin Ultrasound 32:115,122, 2004 [source] Preclinical study of endoscopic ultrasonography with electronic radial scanning echoendoscopeJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 7 2003KATSUSHI NIWA Background: To evaluate the imaging possibility of a newly designed electronic radial scanning echoendoscope (ER-ES). Methods: In the in vivo study of swine, we obtained B-mode endoscopic ultrasonography (EUS) images of the gastric and gallbladder (GB) walls and checked the ability to detect Doppler signals using ER-ES and electronic linear array echoendoscope (EL-ES). Furthermore, in the ex vivo study of swine, B-mode EUS images of fixed gastric and GB wall specimens were obtained using ER-ES, EL-ES and mechanical radial scanning echoendoscope (MR-ES). In the study of resected human specimens, we obtained B-mode EUS images of five resected GB specimens (three normal GB, one cholecystitis and one cancerous) using the three types of echoendoscope. Results: In the in vivo study of swine, ER-ES and EL-ES depicted the gastric walls as five-layered, and the GB walls as single-layered structures. The ability to detect Doppler signals was equal between ER-ES and EL-ES. In the ex vivo study of swine, ER-ES, MR-ES and EL-ES equally delineated the gastric walls as five-layered and GB walls as three-layered structures. In the study of resected human specimens, results demonstrated the normal GB walls as three-layered, the cholecystitis as a combination of outer high-echoic and inner low-echoic layers, and the cancer as a protruded tumor. Conclusions: We conclude that ER-ES has faculties for making B-mode images as well as EL-ES and MR-ES. In addition, in the in vivo study, ER-ES can analyze blood flow information as well as EL-ES. © 2003 Blackwell Publishing Asia Pty Ltd [source] | ||||||||||