COMPARATIVE ANALYSIS OF PREOPERATIVE ULTRASONOGRAPHY REPORTS WITH INTRAOPERATIVE SURGICAL FINDINGS IN CHOLELITHIASIS

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.

[1]  A. Augustine,et al.  A comprehensive predictive scoring method for difficult laparoscopic cholecystectomy , 2014, Journal of minimal access surgery.

[2]  M. Soltes,et al.  A risk score to predict the difficulty of elective laparoscopic cholecystectomy , 2014, Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques.

[3]  J. Nachnani,et al.  Pre-operative prediction of difficult laparoscopic cholecystectomy using clinical and ultrasonographic parameters. , 2005, Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology.

[4]  J. Everhart,et al.  Prevalence and ethnic differences in gallbladder disease in the United States. , 1999, Gastroenterology.

[5]  P. Vaidya,et al.  Laparoscopic Cholecystectomy in a Private Hospital , 2015 .

[6]  K. Shojania,et al.  Does this patient have acute cholecystitis? , 2003, JAMA.

[7]  S. Sharma,et al.  Predicting difficulties during laparoscopic cholecystectomy by preoperative ultrasound. , 2007, Kathmandu University medical journal.

[8]  G. Gravante,et al.  Subtotal cholecystectomy for "difficult gallbladders": systematic review and meta-analysis. , 2015, JAMA surgery.

[9]  E. Shaffer Gallstone disease: Epidemiology of gallbladder stone disease. , 2006, Best practice & research. Clinical gastroenterology.

[10]  P. Cooperberg,et al.  Real-time ultrasonography. Diagnostic technique of choice in calculous gallbladder disease. , 1980, The New England journal of medicine.

[11]  M. Ahmed,et al.  The correlation between ultrasonography and histology in the search for gallstones. , 2011, Annals of the Royal College of Surgeons of England.

[12]  W. Routh,et al.  Gallbladder stones: imaging and intervention. , 2000, Radiographics : a review publication of the Radiological Society of North America, Inc.

[13]  B. Garra,et al.  Visibility of gallstone fragments at US and fluoroscopy: implications for monitoring gallstone lithotripsy. , 1990, Radiology.

[14]  Accuracy of ultrasound and oral cholecystography in assessing the number and size of gallstones: implications for non-surgical therapy. , 1992, The British journal of radiology.

[15]  E. Shaffer Epidemiology of gallbladder stone disease , 2006 .

[16]  J. Windsor,et al.  Peritoneal gallstones following laparoscopic cholecystectomy: incidence, complications, and management. , 2004, Surgical endoscopy.

[17]  G. Eslick,et al.  Early laparoscopic cholecystectomy is superior to delayed acute cholecystitis: a meta-analysis of case–control studies , 2016, Surgical Endoscopy.

[18]  Kadir Oymen Hancerliogullari,et al.  Role of preoperative sonography in predicting conversion from laparoscopic cholecystectomy to open surgery. , 2015, European journal of radiology.

[19]  D. O'Leary,et al.  Beware the contracted gallbladder - Ultrasonic predictors of conversion. , 2013, The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland.

[20]  M. Stojanović,et al.  Prediction of difficulties in laparoscopic cholecystectomy on the base of routinely available parameters in a smaller regional hospital. , 2014, European review for medical and pharmacological sciences.

[21]  H. Gooszen,et al.  Open, small-incision, or laparoscopic cholecystectomy for patients with symptomatic cholecystolithiasis. An overview of Cochrane Hepato-Biliary Group reviews. , 2010, The Cochrane database of systematic reviews.

[22]  V. Malik,et al.  A Difficult Laparoscopic Cholecystectomy That Requires Conversion to Open Procedure Can Be Predicted by Preoperative Ultrasonography , 2002, JSLS : Journal of the Society of Laparoendoscopic Surgeons.

[23]  Z. Teke,et al.  Predictive factors for conversion to open surgery in patients undergoing elective laparoscopic cholecystectomy. , 2010, Journal of laparoendoscopic & advanced surgical techniques. Part A.

[24]  J R Clarke,et al.  Revised estimates of diagnostic test sensitivity and specificity in suspected biliary tract disease. , 1994, Archives of internal medicine.

[25]  S. Nijhawan,et al.  Epidemiology of gallstones. , 1992, The Journal of the Association of Physicians of India.

[26]  S. Daradkeh,et al.  Preoperative Ultrasonography and Prediction of Technical Difficulties during Laparoscopic Cholecystectomy , 1998, World Journal of Surgery.

[27]  M. Dolapci,et al.  Risk factors resulting in conversion of laparoscopic cholecystectomy to open surgery , 2001, Surgical Endoscopy.