The impact of gallbladder wall thickness in laparoscopic cholecystectomy- A retrospective study

Dr. Utsav Shah; Dr. Naman Patel; Dr. Mukesh Suvera; Dr. Sharad Patel; Dr. Shail Shah

Volume : V, Issue : I, January - 2016

The impact of gallbladder wall thickness in laparoscopic cholecystectomy- A retrospective study

Dr. Utsav Shah, Dr. Naman Patel, Dr. Mukesh Suvera, Dr. Sharad Patel, Dr. Shail Shah

Abstract :

Introduction : Gallbladder wall thickening is an indicator of cholecystitis in patients presenting with symptoms of gallstone disease. Objectives : The aim of the study was to evaluate the impact of gallbladder wall thickness on the outcome of cholecystectomy, rate of conversion to an open procedure, to evaluate any intra or postoperative complications related to it and length of stay. Methodology : This retrospective clinical trial conducted in patients undergoing cholecystectomy by laparoscopic method in a single surgical unit. Out of 73 patients with cholelithiasis on sonography,we encountered group A normal gallbladder wall thickness(3mm) in 36 patients, group B mild to moderately thickened gallbladder(4-6mm) in 24 patients and group C severely thickened gallbladder(7mm or more) in 13 patients. Results : A greater degree of gallbladder thickness as in Group B and Group C is associated with difficulties encountered intraoperatively during cholecystectomy as well as increased postoperative complications as compared to Group A. The duration of operation(>1.5 hrs in 16.6%, 66.67%, 100% in Grp A,B & C respectively), the number of operations converted from laparoscopic to open(2.7%. 12.5%, 46.15% in Grp A, B & C respectively), the presence of adhesions(38.8%, 83.3% & 100% in Grp A,B & C respectively) and the placement of drains(50%, 83.3%, 100% in Grp A, B & C respectively) was more in patients of Group B and C as compared to that of Group A. Conclusion : A greater degree of gallbladder wall thickness is associated with an increased risk of conversion, increased postoperative complications, and longer lengths of stay. Classifying patients according to degree of gallbladder wall thickness gives more accurate assessment of the risk of surgery, as well as potential outcomes