The role of transabdominal ultrasound examination in the diagnosis of acute calculous cholecystitis
DOI:
https://doi.org/10.15574/PS.2025.3(88).7681Keywords:
acute calculous cholecystitis, ultrasound examination, laparoscopic cholecystectomyAbstract
In the structure of emergency surgical care, acute calculous cholecystitis takes the second place, ahead of acute appendicitis and second only to acute pancreatitis. And therefore, the search and development of optimal approaches to the diagnosis and surgical treatment of acute calculous cholecystitis continues, with the development and improvement of the relevant recommendations and guidelines.
Aim - to assess the place and role of preoperative ultrasound examination in the diagnosis of acute calculous cholecystitis and predicting the results of early laparoscopic cholecystectomy.
Materials and methods. A retrospective analysis of the treatment of 685 patients with uncomplicated acute calculous cholecystitis during 2021-2024 was conducted. The location of the gallbladder, its size, thickness and condition of the walls, the nature of the contents, the presence of calculi in the gallbladder cavity and their mobility, the condition of the extrahepatic bile ducts, the presence or absence of infiltrates and fluid formations near the gallbladder were assessed. Statistical processing was performed using the statistical software package (SPSS) 20.0 for Windows.
Results. The main method of visualization of acute calculous cholecystitis was ultrasound, which was performed in 100% of patients, which allowed in most cases (93.8%), to diagnose the disease with its sonographic characteristics. Among the ultrasound symptoms that highest predict difficult laparoscopic surgery were: gallstone disease, thickened gallbladder wall, gallbladder neck stone and presence of pericholecystic fluid. They can be used in predicting the need for open surgery, as they are indicators of the fact that laparoscopy can be significantly complicated due to the development of an inflammatory-destructive process.
Conclusions. Ultrasound is a simple, non-invasive, widely available and highly informative method of the first line of visualization of acute calculous cholecystitis, which in 93.8% of cases allows to confirm the diagnosis with a general sensitivity of 93.4% and specificity of 82.3%. The presence of three or more ultrasound symptoms of acute calculous cholecystitis has almost 100% informativeness in its diagnosis.
The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of the institution mentioned in the paper. Informed consent of patients was obtained for the study.
The authors declare no conflict of interest.
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