LAPAROSCOPIC CHOLECYSTECTOMY - POSTOPERATIVE SONOGRAPHIC FINDINGS

Seventeen consecutive patients undergoing elective laparoscopic cholec ystectomy (LC) were serially evaluated with transabdominal ultrasound before, one day after, and six days after LC to document what, if any, changes occur in the surgical bed and surrounding parenchyma. The mos t common postoperative finding was focal sonolucency in the hepatic pa renchyma adjacent to the gallbladder fossa in six (35%) of 17 patients . Five patients (29%) had postoperative fluid collections in the gallb ladder fossa; in four of these five, it was technically difficult to d issect the gallbladder from the liver at the time of original surgery. In one patient the fluid resolved by the sixth postoperative day. It persisted in the remaining four. Two patients had transient ductal dil ation and one had pneumobilia. Shadowing and ring-down artifact was id entified in 12 patients due to surgical clips in the triangle of Calot . Because gallbladder fossa fluid may persist up to six days after unc omplicated laparoscopic cholecystectomy, caution should be used before attaching significance to isolated imaging findings. Clinical judgeme nt remains the best means of selecting which patients need additional evaluation.