Laparoscopic cholecystectomy (LC): predictive role of preoperative ultrasounds.
OBJECTIVE
We studied several ultrasounds patterns concerning gallbladder, biliary tract and gallstones to identify some predictive signs of difficulties during LC.


METHODS
112 patients (24 females), 25-75 years old, upper abdomen operated patients not included. From 7 ultrasounds patterns 4 degrees of potential intra-operative difficulty (0-3) were obtained. During the operation 7 conditions of true intra-operative problems were also classified.


RESULTS
Patients showing grade 0: regular gallbladder wall stones < 20 mm, regular Main Biliary Tract (MBT) = 62 LC and 2 open surgery conversion (OSC); grade 1: wall < 4 mm, stones > 20 mm= 24 LC and 7 OSC; grade 2: hydrops, wall > 4 mm, infundibular stone = 6 LC and 6 OSC, grade 3: wall > 4 mm, stones > 20 mm, empyema of gallbladder, MBT > or = 6 mm = 3 LC and 0 OSC. Inflammation near gallbladder and wall > 4 mm were mainly responsible for transition of LC in OSC.


CONCLUSIONS
Several predictive conditions for intraoperative difficulties are often detectable by accurate preoperative ultrasounds examination, with the aim of best surgical planning and to select those patients to entrust to surgeons during their learning phase.
Minutolo
V
V
First Surgical Department, Clinical Division of General Surgery, University Policlinic of Catania, Italy.
Gagliano
G
G
Rinzivillo
C
C
Minutolo
O
O
Scilletta
B
B
Li Destri
G
G
D000328:Adult; D000368:Aged; D017081:Cholecystectomy, Laparoscopic; D002769:Cholelithiasis / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography