Assessment of an Intraoperative Vessel Detection Technique for Laparascopic Cholecystomy Using a Doppler Ultrasonic Blood Flowmeter

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  • MAEMURA Kosei
    Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences
  • SHINCHI Hiroyuki
    Kagoshima University Graduate School of Health Sciences
  • MATAKI Yuko
    Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences
  • MORI Shinichirou
    Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences
  • TAKAO Sonshin
    Frontier Science Research Center, Kagoshima University
  • NATSUGOE Shoji
    Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences

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Other Title
  • ドップラー血流計による術中血管同定法併用腹腔鏡下胆嚢摘出術
  • 臨床経験 ドップラー血流計による術中血管同定法併用腹腔鏡下胆囊摘出術
  • リンショウ ケイケン ドップラー ケツリュウケイ ニ ヨル ジュッチュウ ケッカン ドウテイホウ ヘイヨウ フククウキョウ カ タンノウ テキシュツジュツ

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Abstract

Objective : We aimed to assess an intraoperative vessel detection technique using the Doppler ultrasonic (Doppler US) flowmeter for laparoscopic cholecystectomy (LC).<BR>Methods : A total of 13 consecutive patients who underwent LC by the reduced port technique at our hospital were evaluated for right hepatic artery (RHA) and cystic artery (CA), using enhanced computed tomography (CT) preoperatively and the Doppler US flowmeter intraoperatively. We analyzed the flow speed and waveforms of each artery, as detected by the Doppler US flowmeter. The detection rate with the Doppler US flowmeter and that with CT were compared for each artery.<BR>Results : RHA was detected by CT in 12 patients ; the Doppler US flowmeter was used for RHA detection in all the patients. CA was detected by CT in 8 patients and by the Doppler US flowmeter in 12 patients. The maximum flow speed (mean ± SD) was 30.3 cm/s in patients with RHA and 8.13 cm/s in those with CA (p < 0.001). The difference between the waveform pattern of the RHA and that of CA acquired by the Doppler US flowmeter was evident. Moreover, no postoperative complications were noted in any patient.<BR>Conclusions : The vessel detection technique using the Doppler US flowmeter was relatively simple and easy to perform for RHA and CA during LC. Therefore, we suggest that this procedure be implemented to improve the safety of LC.

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