Surgeon attitudes toward point of care ultrasound for biliary disease: a nationwide Canadian survey

Surgeon attitudes toward point of care ultrasound for biliary disease: a nationwide Canadian survey

Can J Surg 2020;63(1):E9-E12 | PDF

Jennifer Koichopolos, MD; Richard Hilsden, MD, MBA; Frank Myslik, MD; Drew Thompson, MD; Jeremy Vandelinde, BSc; Rob Leeper, MD, MEHP

Summary

Multiple studies confirm that point of care ultrasound (PoCUS) has a high sensitivity and specificity for cholelithiasis and cholecystitis. However, there is poor perceived reliability of biliary PoCUS by surgeons. This survey was performed to assess surgeons’ opinions on using PoCUS in gallstone disease and barriers that exist for its institution. The majority (60.3%) of respondents reported a total lack of confidence in PoCUS for the diagnosis of biliary disease. Most felt the sensitivity of PoCUS was poor and had concerns about the user-dependent nature of the test and the lack of imaging details provided. If offered ideal clinical/laboratory findings with PoCUS results, only 4.7% of surgeons would definitely operate for unremitting biliary colic and 5.4% for cholecystitis. The ability to replicate findings independently increased confidence in clinical decision-making. Our findings suggest there is substantial distrust in biliary PoCUS but that specific ultrasound training for the surgical workforce may prove tremendously beneficial for its utilization.


Accepted Apr. 24, 2019

Affiliations: From the Division of Emergency Medicine, Western University, London, Ont. (Thompson, Myslik); the Department of Surgery, Western University, London, Ont. (Koichopolos, Leeper); the Division of Critical Care Medicine, Western University, London, Ont. (Leeper); and the Schulich School of Medicine and Dentistry, Western University, London, Ont. (Vandelinde).

Competing interests: R. Leeper is an associate editor of CJS; he was not involved in the review of or decision to accept this paper for publication. No other competing interests were declared.

Contributors: All authors contributed substantially to the conception, writing and revision of this article and approved the final version for publication.

DOI: 10.1503/cjs.010218

Correspondence to: W.R. Leeper, Department of Surgery, Western University, Rm E2-215, London Health Sciences Centre, Victoria Hospital, 800 Commissioners Rd East, London ON N6A 5W9, rob.leeper@lhsc.on.ca