98 Detecting CBD Stones Without Radiation: The Accuracy of Laparoscopic Intraoperative Ultrasound

Abstract Aim This study explores how accurate Intraoperative ultrasound (IOUS) is in detecting CBD stones in surgical practice. Method We reviewed patients undergoing laparoscopic cholecystectomy with IOUS over 7 years at a UK district general hospital. IOUS findings were compared with preoperative MRCP when available and confirmed intraoperatively with either transcystic exploration or on-table cholangiography as needed. We calculated the sensitivity, specificity, and predictive values of IOUS in detecting CBD stones. Results A total of 1018 patients were included (Those not known to have cbd stones preoperatively). IOUS identified stones in 340 patients. Overall, IOUS achieved a sensitivity of 98.9 % and specificity of 99.2%. Importantly, the use of IOUS reduced the need for on-table cholangiography to almost 0% over the year 2024, simplifying intraoperative decision-making. Conclusions In our experience, laparoscopic intraoperative ultrasound is a reliable and practical tool for detecting CBD stones during laparoscopic cholecystectomy. Its high accuracy, ease of use, and ability to reduce the need for additional intraoperative imaging make it a valuable addition to the gallbladder surgery, supporting safe and efficient patient care.