THE VALUE OF ULTRASOUND MEASUREMENT OF GALLBLADDER WALL THICKNESS IN PREDICTING LAPAROSCOPIC OPERABILITY PRIOR TO CHOLECYSTECTOMY

We prospectively analysed 51 consecutive cases who underwent laparosco pic cholecystectomy from June 1992 to February 1993. There were 35 cas es of chronic cholecystitis and 16 cases of acute cholecystitis, All u nderwent pre-operative ultrasonography, complete blood cell count, liv er function test and endoscopic retrograde cholangiopancreatography. O f those 44 had post-operative ultrasound within the first 2 d and agai n on the seventh day, In 35 cases of chronic cholecystitis, 31 of 32 c ases with a pre-operative gallbladder (GB) wall thickness of less than 6 mm were successfully resected laparoscopically. All three cases wit h a GB wall thicker than 6 mm were converted to open cholecystectomy, In acute cholecystitis, the wall thickness of the laparoscopic cholecy stectomy group ranged from 2 to 9 mm (average 4 mm) and the wall thick ness of the conversion group was 4-7 mm (average 6 mm). Post-operative fluid accumulation was noted in 28 (63.6%) cases, There was no correl ation between post-operative pyrexia, duration of post-operative pain, clinical complications and the presence of fluid accumulation in the GB fossa. However, of four cases with increasing fluid on the seventh day, three developed complications. We conclude that ultrasonography i s valuable in chronic cholecystitis for selecting cases for laparoscop ic cholecystectomy.