CORRELATION AMONG ULTRASONOGRAPHIC AND VIDEOSCOPIC FINDINGS OF THE GALLBLADDER - SURGICAL DIFFICULTIES AND REASONS FOR CONVERSION DURING LAPAROSCOPIC SURGERY

Laparoscopic cholecystectomy is currently the standard procedure for c hronic and acute cholecystitis. The purpose of this prospective study was to evaluate the preoperative ultrasound findings of the gallbladde r and correlate those aspects with surgical videoscopic and histopatho logic findings and the results concerning intraoperative complications and the conversion index to open surgery. Gallbladder findings were c lassified into three categories according to the gallbladder wall char acteristics and the presence of visible lumen and stones. Simple chron ic cholecystitis (type I) and acute cholecystitis, with gallbladder wa ll thickness <5 mm (type IIa) presented significantly lower intraopera tive complications without conversion to open surgery. Scleroatrophic (type III) and acute cholecystitis with gallbladder wall thickness <5 mm (type IIB) presented significantly more surgical difficulties and a higher conversion rate to open surgery (p < 0.01). We postulate that this classification will be useful for surgeons in predicting potentia l problems in individual patients, at least at the initial laparoscopi c cholecystectomy experience, and in advising patients of the potentia l risks of and conversion to open surgery.