Rebecca E Barnett1, Yousef Ibrahim2, James Ansell3, Rhys Thomas2, Kimberly Da Costa2, Ashraf Rasheed2. 1. Gwent Centre for Digestive Diseases, Royal Gwent Hospital, Newport, NP20 2UB, Wales, UK. drrebeccaebarnett@gmail.com. 2. Gwent Centre for Digestive Diseases, Royal Gwent Hospital, Newport, NP20 2UB, Wales, UK. 3. Department of General Surgery, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, Wales, UK.
Abstract
BACKGROUND: Limited evidence exists describing the optimum protocol for intraoperative cholangiography (IOC) during laparoscopic cholecystectomy (LC). Images saved during surgery often fail to highlight the necessary anatomical landmarks and documentation is variable. Our aim was to identify the key characteristics of an optimal IOC and evaluate current practice at our institution. METHODS: A literature search identified quality indicators for performing IOC and documenting key findings. A standardised proforma for scoring IOC was developed. Retrospective analysis was conducted of consecutive IOCs performed during elective LC. Visual documentation of seven anatomical landmarks on the captured IOC images and textual reporting in the operation note were assessed. RESULTS: One hundred IOCs were evaluated. Only 32 (34%) of captured images had all 7 landmarks present. All cases failed to document all seven landmarks. There was a significant difference between landmarks that could be identified on the captured images and their documentation. CONCLUSIONS: This study suggests that IOC image capture of the key seven landmarks and their textual reporting in this cohort is sub-optimal. We believe IOC technique, minimal data set for reporting and image capture should be standardised to allow better communication of findings and facilitate meaningful comparative research relating to the subject.
BACKGROUND: Limited evidence exists describing the optimum protocol for intraoperative cholangiography (IOC) during laparoscopic cholecystectomy (LC). Images saved during surgery often fail to highlight the necessary anatomical landmarks and documentation is variable. Our aim was to identify the key characteristics of an optimal IOC and evaluate current practice at our institution. METHODS: A literature search identified quality indicators for performing IOC and documenting key findings. A standardised proforma for scoring IOC was developed. Retrospective analysis was conducted of consecutive IOCs performed during elective LC. Visual documentation of seven anatomical landmarks on the captured IOC images and textual reporting in the operation note were assessed. RESULTS: One hundred IOCs were evaluated. Only 32 (34%) of captured images had all 7 landmarks present. All cases failed to document all seven landmarks. There was a significant difference between landmarks that could be identified on the captured images and their documentation. CONCLUSIONS: This study suggests that IOC image capture of the key seven landmarks and their textual reporting in this cohort is sub-optimal. We believe IOC technique, minimal data set for reporting and image capture should be standardised to allow better communication of findings and facilitate meaningful comparative research relating to the subject.
Authors: J Engstrand; L F Abreu de Carvalho; D Aghayan; A Balakrishnan; A Belli; B Björnsson; B V M Dasari; O Detry; M Di Martino; B Edwin; J Erdmann; R Fristedt; G Fusai; T Gimenez-Maurel; O Hemmingsson; C Hidalgo Salinas; B Isaksson; A Ivanecz; F Izzo; W T Knoefel; P Kron; N Lehwald-Tywuschik; M Lesurtel; J P A Lodge; N Machairas; M V Marino; V Martin; A Paterson; J Rystedt; P Sandström; A Serrablo; A K Siriwardena; H Taflin; T M van Gulik; S Yaqub; I Özden; J M Ramia; C Sturesson Journal: BJS Open Date: 2021-07-06