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Localization of Common Duct Stones by Ultrasound

Localization of Common Duct Stones by Ultrasound Abstract PRECISE localization of gallstones within the common duct remains a technical challenge despite numerous techniques devised for their easy identification. Approximately 10% of patients coming to surgery with cholelithiasis have stones within the common duct1,2 and at least 4% are reported3 to have retained stones even after the most thorough exploration. The value of operative cholangiography is undisputed, but even with this aid and meticulous operative technique, elusive stones may lie undetected within the liver, or hidden in diverticula along the common duct. This is a study of two methods for localizing common duct stones. The first utilizing radioactive labeled dye which adheres to these stones; the second by ultrasound (sonar). Materials and Methods Part I: Radioisotope Labeling. —Administration of cholecystographic dyes for each of three days prior to radiologic examination has been shown to form an opaque concentration of dye as a "rim" or "halo" on the References 1. Purchased from the Abbott Laboratories. 2. Nuclear Chicago Model D58-1. 3. These patients were studied by Dr. William Silen and Dr. W. Heere at the San Francisco County Hospital. 4. Ekoline 20, Smith Kline Precision Co., Philadelphia. 5. Glenn, F.: Common Duct Exploration for Stones , Surg Gynec Obstet 95:431, 1952. 6. Cattell, R. B.: Use of Long T-tube in Surgery of Biliary Tract , Surg Clin N Amer 28:659, 1948. 7. Hicken, N. F., and McAllister, A. J.: Operative Cholangiography as Aid in Reducing Incidence of "Overlooked" Common Bile Duct Stones: Study of 1,293 Choledocholithotomies , Surgery 55:753, 1964. 8. Salzman, E.; Spurck, R.; and Watkins, D. H.: X-ray Diagnosis of Bile Duct Calculi , Gastroenterology 37:587, 1959. 9. Salzman, E., et al: Opacifying Gallstones , JAMA 169:334, 1959.Crossref 10. Cobo, A., et al: Intrahepatic Calculi , Arch Surg 89:936, 1964.Crossref 11. Thomas, C. G.; Linker, R. L.; and Morris, W. H.: Isotopic Labeling of Biliary Tract Stones , Surg Forum 10:254, 1959. 12. Ludwig, G. D., and Struthers, F. W.: Considerations Underlying Use of Ultrasound to Detect Gallstones and Foreign Bodies in Tissue , Report No. 4, Project N.M. 004:001, Bethesda, Md: Naval Medical Research Institute, National Naval Medical Center, June 16, 1949. 13. Fry, W. J., et al: Production of Focal Destructive Lesions in Central Nervous System With Ultrasound , J Neurosurg 11:471, 1954.Crossref 14. Leksell, L.: Echoencephalography Detection of Intracranial Lesion Following Injury , Acta Chir Scand 110:301, 1956. 15. Effert, S.; Erkens, H.; and Grosse-Brockhuff, F.: Uber die Anwendung des Ultraschall-Echoverfahrens in der Herzdiagnostik , Deutsch Med Wschr 82:1253, 1957.Crossref 16. Kikuchi, Y., et al: Early Cancer Diagnosis Through Ultrasonics , J Acoust Soc Amer 29:824, 1957. 17. Donald, I.; MacVicar, J.; and Brown, T. G.: Investigation of Abdominal Masses by Pulsed Ultrasound , Lancet 1:1188, 1958.Crossref 18. Gurevi, M. D., and Sobakin, M. A.: Some Viewpoints on the Use of Ultrasound in Diagnosis of Internal Disorders, Vresojuzu, naucnoissl inst med instrumentov i oberndovanija. 4, 1960. 19. Schlegel, J. U.; Diggdon, P.; and Cuellar, J.: Use of Ultrasound for Localizing Renal Calculi , J Urol 86:367, 1961. 20. Hayashi, S., et al: Ultrasonic Diagnosis of Breast Tumor and Cholelithiasis , Western J Surg 70:34, 1962. 21. Holmes, J. H., and Howry, D. H.: Ultrasonic Diagnosis of Abdominal Disease , Amer J Dig Dis 8:12, 1963.Crossref 22. Knight, P. R., and Newell, J. A.: Operative Use of Ultrasonics in Cholelithiasis , Lancet 1:1023, 1963.Crossref 23. French, L. A.; Wild, J. J.; and Neal, D.: Attempt to Determine Harmful Effect of Pulsed Ultrasonic Vibrations , Cancer 4:342, 1951.Crossref 24. Gallagher, J. Q.; Greenlaw, R. H.; and Eiseman, B.: Localization of Biliary Tract Stones by Isotopic Labeling , Surg Forum 13:262, 1962. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Localization of Common Duct Stones by Ultrasound

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Publisher
American Medical Association
Copyright
Copyright © 1965 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1965.01320130197023
Publisher site
See Article on Publisher Site

Abstract

Abstract PRECISE localization of gallstones within the common duct remains a technical challenge despite numerous techniques devised for their easy identification. Approximately 10% of patients coming to surgery with cholelithiasis have stones within the common duct1,2 and at least 4% are reported3 to have retained stones even after the most thorough exploration. The value of operative cholangiography is undisputed, but even with this aid and meticulous operative technique, elusive stones may lie undetected within the liver, or hidden in diverticula along the common duct. This is a study of two methods for localizing common duct stones. The first utilizing radioactive labeled dye which adheres to these stones; the second by ultrasound (sonar). Materials and Methods Part I: Radioisotope Labeling. —Administration of cholecystographic dyes for each of three days prior to radiologic examination has been shown to form an opaque concentration of dye as a "rim" or "halo" on the References 1. Purchased from the Abbott Laboratories. 2. Nuclear Chicago Model D58-1. 3. These patients were studied by Dr. William Silen and Dr. W. Heere at the San Francisco County Hospital. 4. Ekoline 20, Smith Kline Precision Co., Philadelphia. 5. Glenn, F.: Common Duct Exploration for Stones , Surg Gynec Obstet 95:431, 1952. 6. Cattell, R. B.: Use of Long T-tube in Surgery of Biliary Tract , Surg Clin N Amer 28:659, 1948. 7. Hicken, N. F., and McAllister, A. J.: Operative Cholangiography as Aid in Reducing Incidence of "Overlooked" Common Bile Duct Stones: Study of 1,293 Choledocholithotomies , Surgery 55:753, 1964. 8. Salzman, E.; Spurck, R.; and Watkins, D. H.: X-ray Diagnosis of Bile Duct Calculi , Gastroenterology 37:587, 1959. 9. Salzman, E., et al: Opacifying Gallstones , JAMA 169:334, 1959.Crossref 10. Cobo, A., et al: Intrahepatic Calculi , Arch Surg 89:936, 1964.Crossref 11. Thomas, C. G.; Linker, R. L.; and Morris, W. H.: Isotopic Labeling of Biliary Tract Stones , Surg Forum 10:254, 1959. 12. Ludwig, G. D., and Struthers, F. W.: Considerations Underlying Use of Ultrasound to Detect Gallstones and Foreign Bodies in Tissue , Report No. 4, Project N.M. 004:001, Bethesda, Md: Naval Medical Research Institute, National Naval Medical Center, June 16, 1949. 13. Fry, W. J., et al: Production of Focal Destructive Lesions in Central Nervous System With Ultrasound , J Neurosurg 11:471, 1954.Crossref 14. Leksell, L.: Echoencephalography Detection of Intracranial Lesion Following Injury , Acta Chir Scand 110:301, 1956. 15. Effert, S.; Erkens, H.; and Grosse-Brockhuff, F.: Uber die Anwendung des Ultraschall-Echoverfahrens in der Herzdiagnostik , Deutsch Med Wschr 82:1253, 1957.Crossref 16. Kikuchi, Y., et al: Early Cancer Diagnosis Through Ultrasonics , J Acoust Soc Amer 29:824, 1957. 17. Donald, I.; MacVicar, J.; and Brown, T. G.: Investigation of Abdominal Masses by Pulsed Ultrasound , Lancet 1:1188, 1958.Crossref 18. Gurevi, M. D., and Sobakin, M. A.: Some Viewpoints on the Use of Ultrasound in Diagnosis of Internal Disorders, Vresojuzu, naucnoissl inst med instrumentov i oberndovanija. 4, 1960. 19. Schlegel, J. U.; Diggdon, P.; and Cuellar, J.: Use of Ultrasound for Localizing Renal Calculi , J Urol 86:367, 1961. 20. Hayashi, S., et al: Ultrasonic Diagnosis of Breast Tumor and Cholelithiasis , Western J Surg 70:34, 1962. 21. Holmes, J. H., and Howry, D. H.: Ultrasonic Diagnosis of Abdominal Disease , Amer J Dig Dis 8:12, 1963.Crossref 22. Knight, P. R., and Newell, J. A.: Operative Use of Ultrasonics in Cholelithiasis , Lancet 1:1023, 1963.Crossref 23. French, L. A.; Wild, J. J.; and Neal, D.: Attempt to Determine Harmful Effect of Pulsed Ultrasonic Vibrations , Cancer 4:342, 1951.Crossref 24. Gallagher, J. Q.; Greenlaw, R. H.; and Eiseman, B.: Localization of Biliary Tract Stones by Isotopic Labeling , Surg Forum 13:262, 1962.

Journal

Archives of SurgeryAmerican Medical Association

Published: Jul 1, 1965

References