The degree of gallbladder wall thickness and its impact on outcomes after laparoscopic cholecystectomy

Raman, Shankar; Moradi, Dovid; Samaan, Bassem M.; Chaudhry, Umar S.; Nagpal, Kamal; Cosgrove, John M.; Farkas, Daniel T.

doi:10.1007/s00464-012-2310-8

Cited by 35 publications

(44 citation statements)

References 24 publications

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“…Gall bladder wall thickness is not a good indicator of mucosal hyperplasia or cholecystitis in dogs, 20,26 although in people, gall bladder wall thickness can be predictive of laparoscopic operability. 27,28 Two dogs that required open cholecystectomy had a gall bladder wall thickness greater than normal (2-3 mm). 21,29 Preoperative abdominal ultrasound examination showed evidence of localized inflammation around the cystic duct in 1 dog.…”

Section: Discussionmentioning

confidence: 99%

“…24,50 Predictive factors for conversion to open cholecystectomy in people include increased white blood cell count, ultrasound findings of pericholecystic fluid, low serum albumin, elevated serum total bilirubin, right cranial abdominal pain during ultrasound, being male, obesity, comorbidities, and the presence of a thickened gall bladder wall. 13,28,31,49 Since the pathogenesis of disease differs in canines, [9][10][11][12]19,22 extrapolation of risk factors from people is not possible; however, careful consideration of preoperative imaging and the clinical status of the dog is imperative for successful laparoscopic cholecystectomy. We did not find any factors related to conversion to open cholecystecomy in our study.…”

Section: Discussionmentioning

confidence: 99%

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Perioperative Complications and Outcome of Laparoscopic Cholecystectomy in 20 Dogs

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Perioperative Complications and Outcome of Laparoscopic Cholecystectomy in 20 Dogs

et al. 2016

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“…As far as surgical outcomes go, a conversion rate of 4% and surgical and medical complication rate of 1% and 10%, respectively, is in keeping with the rates reported in the literature. 20 Some studies show poorer outcomes based on gallbladder wall thickness 20,21 and delayed surgery. Our study showed that wall thickness of 5 mm or more was associated with acute cholecystitis, necrosis and increased duration of surgery, but conversions, complications and length of stay were similar.…”

Section: Discussionmentioning

confidence: 99%

Does ultrasonography accurately diagnose acute cholecystitis? Improving diagnostic accuracy based on a review at a regional hospital

2014

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Background: Acute cholecystitis is one of the most common diseases requiring emergency surgery. Ultrasonography is an accurate test for cholelithiasis but has a high falsenegative rate for acute cholecystitis. The Murphy sign and laboratory tests performed independently are also not particularly accurate. This study was designed to review the accuracy of ultrasonography for diagnosing acute cholecystitis in a regional hospital. Methods:We studied all emergency cholecystectomies performed over a 1-year period. All imaging studies were reviewed by a single radiologist, and all pathology was reviewed by a single pathologist. The reviewers were blinded to each other's results.Results: A total of 107 patients required an emergency cholecystectomy in the study period; 83 of them underwent ultrasonography. Interradiologist agreement was 92% for ultrasonography. For cholelithiasis, ultrasonography had 100% sensitivity, 18% specificity, 81% positive predictive value (PPV) and 100% negative predictive value (NPV). For acute cholecystitis, it had 54% sensitivity, 81% specificity, 85% PPV and 47% NPV. All patients had chronic cholecystitis and 67% had acute cholecystitis on histology. When combined with positive Murphy sign and elevated neutrophil count, an ultrasound showing cholelithiasis or acute cholecystitis yielded a sensitivity of 74%, specificity of 62%, PPV of 80% and NPV of 53% for the diagnosis of acute cholecystitis. Conclusion:Ultrasonography alone has a high rate of false-negative studies for acute cholecystitis. However, a higher rate of accurate diagnosis can be achieved using a triad of positive Murphy sign, elevated neutrophil count and an ultrasound showing cholelithiasis or cholecystitis.Contexte : La cholécystite aiguë est l'une des maladies les plus répandues exigeant une chirurgie d'urgence. L'échographie est un test précis pour le dépistage de la cholélithiase, mais elle s'accompagne d'un taux élevé de diagnostics faux-négatifs de cholécystite aiguë. Le signe de Murphy et les analyses de laboratoire effectuées indépendamment ne sont pas non plus particulièrement précis. Cette étude a été conçue pour vérifier la précision de l'échographie dans le diagnostic de la cholécystite aiguë dans un hôpital régional.Méthodes : Nous avons passé en revue toutes les cholécystectomies d'urgence effectuées sur une période d'un an. Toutes les épreuves d'imagerie ont été examinées par un seul radiologue et toutes les analyses d'anatomopathologie, par un seul anatomopathologiste. Les examinateurs n'étaient pas au courant de leurs conclusions respectives.Résultats : En tout, 107 patients ont eu besoin d'une cholécystectomie d'urgence au cours de la période de l'étude; 83 ont subi une échographie. La concordance d'opinion entre les radiologues a été de 92 % en ce qui concerne l'échographie. Pour la cholélithiase, l'échographie a présenté une sensibilité de 100 %, une spécificité de 18 %, une valeur prédictive positive (VPP) de 81 % et une valeur prédictive négative (VPN) de 100 %. En ce qui concerne la cholécystite aiguë...

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“…Increased thickness of the gallbladder wall up to 9 mm (normal #3 mm) 17,18 was seen in 10 patients (29%). Eight patients (24%) had polyps with a diameter exceeding 5 mm in 6 patients, with a maximum of 13 mm (table 1).…”

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confidence: 99%

Gallbladder and the risk of polyps and carcinoma in metachromatic leukodystrophy

et al. 2016

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Our results demonstrate that gallbladder involvement is the rule rather than the exception in MLD. The high prevalence of hyperplastic polyps, a known precancerous condition, and one death from gallbladder carcinoma at a young age suggest that MLD predisposes to neoplastic gallbladder abnormalities. As novel therapies for this patient group are emerging leading to increased life expectancy, we recommend screening for gallbladder abnormalities by ultrasound in order to prevent early death.

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The degree of gallbladder wall thickness and its impact on outcomes after laparoscopic cholecystectomy

Cited by 35 publications

References 24 publications

Perioperative Complications and Outcome of Laparoscopic Cholecystectomy in 20 Dogs

Perioperative Complications and Outcome of Laparoscopic Cholecystectomy in 20 Dogs

Does ultrasonography accurately diagnose acute cholecystitis? Improving diagnostic accuracy based on a review at a regional hospital

Gallbladder and the risk of polyps and carcinoma in metachromatic leukodystrophy

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