Utility of routine ultrasound after laparoscopic cholecystectomy to detect early postoperative complication.
OBJECTIVE
In up to 3% of laparoscopic cholecystectomies, procedure-related complications occur. Routine postoperative ultrasound is one means of screening for these complications. The aim of this study was to determine the utility of this practice after laparoscopic cholecystectomy.


METHODS
A series of consecutive patients (n = 1,044) undergoing laparoscopic cholecystectomy from January 2007 to January 2011 was analysed. Primary endpoint was the detection of procedure-related complications by routine ultrasound.


RESULTS
Routine ultrasound within the first 48 h after laparoscopic cholecystectomy was performed in 967 of 1,044 patients. Overall, 25 (2.4%) of the 1,044 patients suffered from procedure-related complications, but only in 2 patients was the complication detected by routine ultrasound. Findings were false-positive in 103 patients. This corresponds to a sensitivity of 8% and a specificity of 89%. Hospital stay was prolonged in the false-positive group.


CONCLUSIONS
Routine postoperative ultrasound has a low sensitivity for the detection of complications after laparoscopic cholecystectomy. In almost all cases, the diagnosis is initiated by clinical findings. Therefore, routine ultrasound is of limited value in screening for postoperative complications after cholecystectomy.
Working Group for Experimental Minimally Invasive Surgery and Training, Clinic for Visceral, General and Transplant Surgery, Tübingen University Hospital, Tübingen, Germany.
Sven
S
Müller
Claudius
C
Falch
Julia
J
Kreuzer
Pirmin
P
Storz
Alfred
A
Konigsrainer
Andreas
A
Kirschniak
D018784:Abdominal Abscess / Q000000981:diagnostic imaging* / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001652:Bile Ducts / Q000000981:diagnostic imaging* / Q000293:injuries*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D042883:Choledocholithiasis / Q000000981:diagnostic imaging* / Q000209:etiology; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology; D012680:Sensitivity and Specificity; D013997:Time Factors; D014463:Ultrasonography; D055815:Young Adult