Predictive analysis on gall bladder wall thickness as a marker for bleeding risk and need of transfusion in dengue patients.

Background: Laparoscopic cholecystectomy is the gold standard procedure for cholecystitis. There are variable rates of conversion of laparoscopic cholecystectomy to open cholecystectomy. Various studies have highlighted gall bladder wall thickness of > 3mm as an independent risk factor for conversion. The purpose of our study is to predict the feasibility of cholecystectomy laparoscopically bases on the pre-operative ultrasound guided measurement of gall bladder wall thickness.Methods: It is a retrospective study conducted in the Department of Surgery, Himalayan Institute of Medical Sciences (HIMS) from June 2016 to September 2017. Patient’s pre-operative complete haemogram, liver function tests were also analyzed. Gallbladder wall thickness was estimated by using the maximal obtainable measurement at the fundus. A thin gallbladder wall was less than 3 mm in diameter. A thick gallbladder wall was 3 mm or greater in diameter.Results: A total of 192 patients were included in this study. Most of the patients were of the age group between 30-40 years, with average age of 37 years and 70% of the patients were females. Out of 192, 176 patients underwent laparoscopic cholecystectomy and 16 patients required conversion to open surgery. Ninety patients (46.8%) had cholecystectomy for acute cholecystitis and one hundred two patients (53.15%) had cholecystectomy for chronic cholecystitis. The gallbladder wall was found to be greater than 3 mm in 23 patients (25.5%) with acute calculous cholecystitis and greater than 3 mm in 25 patients (24.5%) with chronic calculous cholecystitis. Forty-eight patients, out of a total of 192, had a gallbladder wall thickness greater than 3 mm by preoperative sonography and 16 of these patients (33.3%) required conversion to an open cholecystectomy.Conclusions: Gall bladder wall thickness bases on ultrasound is a good predictor for difficult cholecystectomy and conversion to open surgery.

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Gall bladder Wall Thickness as Non-invasive Predictor of Oesophageal Varices in Cirrhotic Patients

Zagazig University Medical Journal ◽

10.21608/zumj.2021.77155.2239 ◽

2021 ◽

Vol 0 (0) ◽

pp. 0-0

Author(s):

Mohamed Afifi ◽

Mahmoud Rizk ◽

Ahmed Hussein

Keyword(s):

Gall Bladder ◽

Wall Thickness ◽

Bladder Wall ◽

Oesophageal Varices ◽

Bladder Wall Thickness ◽

Non Invasive ◽

Gall Bladder Wall ◽

Cirrhotic Patients

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Gall Bladder Wall Thickness: Sonographic Accuracy and Laparoscopic Cholecystectomy Conversion Rate, Evaluated by Histopathology

Indian Journal of Forensic Medicine & Toxicology ◽

10.37506/ijfmt.v14i4.12022 ◽

2020 ◽

Keyword(s):

Laparoscopic Cholecystectomy ◽

Gall Bladder ◽

Wall Thickness ◽

Conversion Rate ◽

Bladder Wall ◽

Bladder Wall Thickness ◽

Gall Bladder Wall

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Frequency of Gall‐Bladder Wall Thickness in Patients Suffering from Liver Cirrhosis

10.53350/pjmhs211551038 ◽

2021 ◽

Vol 15 (5) ◽

pp. 1038-1043

Author(s):

Muhammad Azam ◽

Amir Hamza ◽

Maqbool Ahmed ◽

Aftab Ahmed ◽

Samina . ◽

...

Keyword(s):

Liver Cirrhosis ◽

Gall Bladder ◽

Wall Thickness ◽

Bladder Wall ◽

Venous Hypertension ◽

Common Finding ◽

Duration Of Symptoms ◽

Bladder Wall Thickness ◽

Gall Bladder Wall ◽

Portal Venous Hypertension

Aim: To evaluate the frequency of gall bladder wall thickness in patients suffering from liver cirrhosis. Study design: Cross-sectional study Place and duration of study: Department of Internal Medicine, Bolan Medical Complex Hospital, Quetta from 01-01-2020 to 31-012-2020. Methodology: Sixty eight diagnosed patients of liver cirrhosis, age ranging between 20 to 60 years, were randomly selected from indoor patient department and they were further evaluated for gall bladder wall thickness.The diagnosis of liver cirrhosis and portal venous hypertension was made by ultrasonography of abdomen, especially hepatobiliary system. The gall bladder wall thickness is also evaluated by ultrasonography. Results: Mean age of the patients was 41.22±8.93 years. There were 35(51.5%) males while female patients were 33(48.5%). The mean duration of symptoms was 6.32±0.57 weeks. The duration of symptoms was ≤6 weeks in 45(66.2%) of patients, while 23(33.8%) of patients were having duration of symptoms >6 weeks. Twenty 20(29.4%) cases of liver cirrhosis patients were presented with gall bladder wall thickness, while rest 48(70.6%) were presented with normal gall bladder wall thickness on USG. Conclusion: The gall‐bladder wall thickness is very common finding associated with liver cirrhosis. It requires no surgical intervention or any other specific medical therapy. Keywords: Gall‐bladder wall thickness; liver cirrhosis; portal venous hypertension; hypoalbuminemia.

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Study of correlation between pre-operative ultrasonographic findings and difficult laparoscopic cholecystectomy

International Surgery Journal ◽

10.18203/2349-2902.isj20182782 ◽

2018 ◽

Vol 5 (7) ◽

pp. 2605

Author(s):

Himanshu Chindarkar ◽

Ramesh Dumbre ◽

Arun Fernandes ◽

Deepak Phalgune

Keyword(s):

Laparoscopic Cholecystectomy ◽

Gall Bladder ◽

Wall Thickness ◽

Bladder Wall ◽

Fluid Collection ◽

Gall Stone ◽

Bladder Wall Thickness ◽

Gall Stones ◽

Proper Patient Selection ◽

Gall Bladder Wall

Background: In laparoscopic cholecystectomy prevention of certain life-threatening complications are dependent on proper patient selection. Some reliable factors to predict difficulty, conversion or complications in laparoscopic cholecystectomy are needed. In the present research attempt was made to study correlation between pre-operative abdominal ultrasonographic findings and difficultly in laparoscopic cholecystectomy.Methods: Sixty patients above age of 18 years with gall stone admitted for elective laparoscopic cholecystectomy were included. Pre-operative ultrasonographic parameters such as gallbladder wall thickness and size, gallstone mobility, common bile duct (CBD) diameter, size and number of calculi, presence of pericholecystic fluid collection were given score of 0 or 1 based on findings being negative or positive respectively. Total score was correlated to intraoperative difficulty of surgery. Operative findings were graded as difficult laparoscopic cholecystectomy if there were presence of dense peri gall bladder adhesions, difficulty in dissection of Calot triangle, tear of gallbladder, bleeding that hindered visual field, abnormal anatomy of biliary tree and buried or intrahepatic gall bladder.Results: Pre-operative USG findings such as gall bladder wall thickness and size, impacted and size of gall stones, CBD diameter, presence of pericholecystic fluid collection were significantly associated with difficult laparoscopic cholecystectomy. Gall bladder wall thickness, pericholecystic fluid collection and impacted gall stones were accurate predictors for difficult laparoscopic cholecystectomy. Higher the pre-operative USG score, higher were the percentage of difficult laparoscopic cholecystectomy and conversion to open cholecystectomy.Conclusions: Pre-operative ultrasonography in the form of the formulated score is a good predictor of difficulty in laparoscopic cholecystectomy.

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Predictive factors for conversion from laparoscopic to open cholecystectomy: an institutional study

International Surgery Journal ◽

10.18203/2349-2902.isj20183210 ◽

2018 ◽

Vol 5 (8) ◽

pp. 2894

Author(s):

Digvijoy Sharma ◽

Kunduru Nava Kishore ◽

Gangadhar Rao Gondu ◽

Venu Madhav Thumma ◽

Suryaramachandra Varma Gunturi ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Gall Bladder ◽

Acute Cholecystitis ◽

Wall Thickness ◽

Open Cholecystectomy ◽

Bladder Wall ◽

Bladder Wall Thickness ◽

Calot’S Triangle ◽

Conversion To Open Cholecystectomy ◽

Gall Bladder Wall

Background: Laparoscopic cholecystectomy has become the gold standard treatment for symptomatic gallstones. However, a conversion to open surgery may be required to complete the procedure safely. The aim of this study is to identify the predictive factors of conversion from laparoscopic to open cholecystectomy in elective setting.Methods: A retrospective review of all patients underwent laparoscopic cholecystectomy electively for symptomatic gallstones from January 2016 to December 2017 was performed. Data considered for analysis were: demographic data, preoperative laboratory values of liver function tests, gall bladder wall thickness on ultrasound, preoperative ERCP, indication for surgery, history of acute cholecystitis, presence of intraoperative adhesions and frozen Calot's triangle. Conversion to open cholecystectomy was chosen as the dependent variable for both, univariate and multivariate analysis.Results: 546 patients underwent laparoscopic cholecystectomy. 333 were females (60.9%) and 213 (39.1%) males, with a mean age of 44.6 years. The most common indication for surgery was symptomatic cholelithiasis. Conversion to open cholecystectomy occurred in 48 cases (8.8%) and the most common reason for conversion was inability to define the Calot’s triangle anatomy due to inflammation/adhesions. Univariate and multivariate analyses of various variables demonstrated that male gender, gall bladder wall thickness >5 mm and presence of previous documented acute cholecystitis had statistically significant co-relation with higher rates of conversion (p<0.001).Conclusions: Presence of acute cholecystitis, gall bladder wall thickness >5mm on preoperative ultrasound and male gender were independent predictor factors for conversion from laparoscopic to open cholecystectomy. Such patients should be properly counselled about the increased risk for conversion and should be operated by surgeons experienced in laparoscopic procedures to reduce the rate of conversion and operative complications.

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Ultrasound Measurement of the Gallbladder Wall Thickness in the Assessment of the Risk of Conversion from Elective Laparoscopic Cholecystectomy to Open Surgery — Olkusz County Experience

Polish Journal of Surgery ◽

10.1515/pjs-2016-0073 ◽

2016 ◽

Vol 88 (6) ◽

Author(s):

Dariusz Kania

Keyword(s):

Laparoscopic Cholecystectomy ◽

Gall Bladder ◽

Wall Thickness ◽

Bladder Wall ◽

Gallbladder Wall ◽

Categorical Variables ◽

Ultrasound Measurement ◽

Intestinal Fistula ◽

Bladder Wall Thickness ◽

Gall Bladder Wall

Abstractwas to assess the risk of intraoperative difficulties, conversion and biliary-intestinal fistula during laparoscopic cholecystectomy on the basis of an ultrasound-measured gall-bladder wall thickness.A prospective study was conducted in 50 patients undergoing laparoscopic cholecystectomy for chronic gallstone-induced cholecystitis. To calculate the relationships between categorical variables, a chi-square (χThe relationship between the gall-bladder wall thickness and the occurrence of intraoperative difficulties in the analysed set is deterministic (AUC = 1), and the wall thickness of ≥ 5 mm allows to predict their occurrence as soon as at the stage of diagnostic evaluation (p < 0.001). In addition, the ultrasound-measured GB wall thickness is a good predictor of conversion (AUC = 0.976; 95% CI 0.444–0.975; p < 0.001) and biliary-intestinal fistula (AUC = 0.935; 95% CI 0.121–0.738; p = 0.001).The results allow prediction of technically difficult laparoscopic cholecystectomies in patients with CCh, and selection of the right surgical team helps to reduce the number of conversions and possible complications. In addition, bearing in mind the above results in everyday practice should facilitate planning and increase effectiveness in the operating room.

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A study on correlation of gall bladder wall thickness with severity of Dengue fever

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20194719 ◽

2019 ◽

Vol 6 (6) ◽

pp. 2476

Author(s):

Vijayalakshmi A. ◽

Sreelekha P. ◽

Kalashankar D.

Keyword(s):

Gall Bladder ◽

Dengue Fever ◽

Wall Thickness ◽

Bladder Wall ◽

Tertiary Care ◽

Fatal Outcome ◽

Warning Signs ◽

Severe Dengue ◽

Bladder Wall Thickness ◽

Gall Bladder Wall

Background: Dengue is an acute viral infection with potentially fatal complications. This study was done to describe the correlation of Gall bladder wall thickness with severity of Dengue fever and to predict the fatal outcome of Dengue fever at the earliest to prevent serious consequences by timely interventions.Methods: This was a hospital based prospective observational study conducted at Niloufer Hospital, a tertiary care pediatric hospital attached to Osmania Medical College, Hyderabad, Telangana, India from October 2017 to November 2018. All children between 1 year to 12 years of age that had clinical features of dengue and who were serologically confirmed were included in this study.Results: Age group most commonly affected was 5-8 years with maximum number of dengue cases without warning signs (55.7%). Majority of severe dengue cases (64.3%) had gall bladder wall thickness >5mm. The correlation between severity of dengue and gall bladder wall thickness was found to be highly significant indicating the higher the severity of dengue more the gall bladder thickness.Conclusions: This study concludes gallbladder wall thickness (GBWT) measured by ultrasonography can be used in children for early prediction of the severity of DHF in children and authors can include gall bladder wall thickness as an admission criteria during epidemics.

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An observational study to assess male gender as an isolated risk factor in the laparoscopic cholecystectomy

International Surgery Journal ◽

10.18203/2349-2902.isj20213133 ◽

2021 ◽

Vol 8 (8) ◽

pp. 2382

Author(s):

Bhupen Songra ◽

Amit Kumar ◽

Mohit Jain ◽

Gaurav Jalendra

Keyword(s):

Risk Factor ◽

Laparoscopic Cholecystectomy ◽

Gall Bladder ◽

Wall Thickness ◽

Bladder Wall ◽

Male Gender ◽

P Value ◽

Bladder Wall Thickness ◽

Gall Bladder Wall ◽

Difficult Cholecystectomy

Background: Laparoscopic cholecystectomy is the procedure of choice for majority of patients with gall bladder disease. The aim of the study was to investigate the role of male gender as an isolated risk factor responsible for the increased peri-operative morbidity of laparoscopic cholecystectomy by excluding associated risk factors.Methods: This was a prospective observational descriptive study 60 cases of elective laparoscopic cholecystectomy admitted to the S. M. S. Hospital from July 2019 to May 2020 were included.Results: The most common age group in male was 41-50 years and in female was 51-60 years. Impacted stones and gall bladder wall thickness >4 mm was causes of difficult cholecystectomy and evenly distributed in both sexes. Operative time (p value=0.268), visual analogue score on day 1 (p value=0.307) and hospital stay (p value=0.376) was more in male group but not statistically significant.Conclusions: Impacted stone and gall bladder wall thickness >4 mm were only factors associated with difficult laparoscopic cholecystectomy and excludes male gender as an isolated risk factor for difficult cholecystectomy however large-scale studies may provide different results.

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