Comparative Analysis of Preoperative Ultrasonography Reports With Intraoperative Surgical Findings in Cholelithiasis

Abstract

Background: Laparoscopic cholecystectomy is widely used for cholelithiasis. Abdominal ultrasonography often precedes this operation and can prove diagnosis, as well as helps in showing possible complications during the perioperative period. Aim: Evaluate the description of variables of gallbladder and bile ducts present in reports of preoperative abdominal ultrasonography in cholelithiasis comparing with surgical findings. Methods: Were studied 91 patients who underwent elective laparoscopic cholecystectomy with previous abdominal ultrasonography. Variables such as identification and amount of gallstones involved were evaluated, both in preoperative ultrasonography and during surgery to evaluate sensitivity, specificity, concordance and positive and negative predictive values. Results: The reports did not mention diameter of vesicular light (98.9%), organ distension (62.6%), gallstone sizes (58.2%), wall thickness (41.8%) and evaluation of the common bile duct (39.6%). Ultrasound had high values for sensitivity, consistency and positive predictive value for identifying the presence/absence of gallstones: 98.8%, 96.7% and 97.8% respectively. As for the amount of stones, ultrasonography showed agreement in 82.7%, negative predictive value in 89.1% and specificity in 87.7%, with lower values for sensitivity (68.2%) and positive predictive value (65.2%). Conclusions: The ultrasound reports were flawed in standardization. Significant percentage of them did not have variables that could predict perioperative complications and surgical conversion.

Outcome of Laparoscopic Cholecystectomy in Patients With Gallstone Disease at a Secondary Level Care Hospital

“…The main risk associated with the LC appears to be a higher incidence of bile duct injury than open cholecystectomy, 0.3-0.8% 9 , 19 .…”

Prevalence of Bacteriobilia in Patients Undergoing Elective Colecystectomy

“…It is estimated, nowadays, that 85% of the patients with cholecystolithiasis keep asymptomatic for at least 10 years. In the last two decades, the knowledge and management evolved in a meaningful way, and a lot of clinical and microbiological parameters have been studied, just like the way how antibiotics and defense systems of biliary tract interfere with the evolution of the infections in bile duct 1 , 4 , 10 , 11 .…”

Diagnostic accuracy of ultrasonography in adults with obstructive jaundice

“…The level of sensitivity obtained in the study is quite comparable to that reported in some previous studies for CT, MRCP, PTC, and ERCP ( 3 , 15 , 26 , 27 ) . We believe that the meticulous, protocol-driven ( 11 , 12 ) use of ultrasound for the diagnosis of obstructive jaundice would further help to improve surgical management.…”

“…In resource-poor settings, ultrasound is often the only readily available method, with many of the other modalities being too expensive or unavailable to many patients. Furthermore, abdominal ultrasound is considered to be the first initial imaging procedure in obstructive jaundice ( 1 , 5 , 11 , 12 ) . Ultrasonography could also be used for some imaging-guided hepatobiliary interventions.…”