To evaluate the application of intraoperative contrast-enhanced ultrasound cholangiography in hepatobiliary surgery.

Clinical data of 23 patients who underwent hepatobiliary surgery in the Second Affiliated Hospital of Guangzhou Medical University from January 1, 2019 to March 3, 2020 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 15 patients were male and 8 female, aged 25-65 years, with a median age of 43 years. Open hepatectomy was performed in 8 cases, open choledocholithotomy + biliary exploration in 4, laparoscopic hepatectomy in 6 and laparoscopic choledocholithotomy + biliary exploration in 5 cases. Intraoperatively, contrast agent was injected into the cystic duct. Contrast-enhanced ultrasound cholangiography was performed to observe the anatomy of intrahepatic bile duct.

Except the initial 3 cases of tentative trial, the contrast-enhanced ultrasound cholangiography of the remaining 20 cases were successfully performed. The structures and lesions of the third and fourth branches of intrahepatic bile ducts could be clearly displayed by intraoperative contrast-enhanced ultrasound cholangiography. The duration of contrast enhancement was 3-5 min. No contrast-related complications or death occurred. Postoperative ascites occurred in 1 case and bile leakage in 1 case. After symptomatic treatments, both patients were recovered and discharged from hospital. No adverse reactions were reported during the postoperative 3-month follow-up.

Contrast-enhanced ultrasound cholangiography is safe and feasible to clearly display the structure of biliary tract and provide information about anatomical structure and lesions of biliary tract for hepatobiliary surgery.