Aim: This study aims to evaluate the accuracy of ultrasonography (US) by comparing preoperative ultrasonographic findings with intraoperative observations during laparoscopic cholecystectomy (LC).
Materials and methods: An observational analytical study was conducted at a tertiary hospital in Pune over two years and included 98 patients aged 20-80 with symptomatic cholelithiasis confirmed by US. Preoperative parameters assessed included gallstone number, gallbladder volume, wall thickness, and pericholecystic fluid. These were compared to intraoperative findings during LC. Data were analyzed using SPSS Statistics for Windows, Version 16 (Released 2007; SPSS Inc., Chicago, Ill), with sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) calculated for the US parameters.
Results: The mean patient age was 44.14±15.06 years, with a female predominance (70%). US showed high sensitivity (78.13%) but low specificity (35.29%) for detecting the number of stones, and showed high specificity (100%) but low sensitivity (21%) in the assessment of gallbladder wall thickness. For detecting gallbladder distension, US had a sensitivity of 69.7% and a specificity of 11.1%, while it achieved perfect sensitivity and NPV (100%) for evaluation of pericholecystic fluid.
Conclusions: Preoperative US provides valuable insights for surgical planning, with high sensitivity and specificity for gallbladder wall thickness and pericholecystic fluid. However, its accuracy in detecting the number of stones and gallbladder distension is moderate. US can be considered a useful investigation for diagnosing cholelithiasis. It may be used to predict the fate of LC, but further studies need to be carried out to confirm its surgical importance.
Keywords: cholelithiasis; gall stone disease (gsd); intraoperative observations; laparoscopic cholecystectomy; preoperative ultrasonography.
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