THE AIM of this study was to analyse the performance of ultrasonography in the diagnosis of gallbladder conditions requiring surgical intervention.
Material and methods: We performed an observational retrospective study for the assessment of ultrasound in patients having symptomatic gallbladder lithiasis.
Results: The study group included 179 patients with a mean age of 59.31 +/- 15.82 years. The Kruskal Wallis test showed statistically significant differences (KW, p=0.00003) between the mean thickness of the gallbladder wall found in the 4 morphological types of cholecystitis. The statistical significance analysis using "Risk Ratio"(RR) and "Odd test"(OR) showed an increased risk in patients having documented gallbladder lithiasis to develop catarrhal cholecystitis (RR=1.19; OR=1.32, 95% CI 0.71-2.44). For the diagnosis of gallbladder lithiasis during acute cholecystitis, we found a 100% sensitivity, 98.7% specificity, with a 98.7% PPV, 100% NPV and a 93.39% method accuracy. For the diagnosis of various types of acute cholecystitis, we found a 89.99% sensitivity, 84.44% specificity, 88.31% PPV, 86.09% NPV, with a 87.35% method accuracy.
Conclusions: Ultrasonography is a method of high accuracy in the diagnosis of gallbladder lithiasis (93.39%) and its complication--acute cholecystitis (87.35%). The risk analysis for the occurrence of gallbladder complications and the increased risk for developing a severe form of acute cholecystitis in patients without documented lithiasis proves the essential contribution of ultrasonography in optimizing emergency surgical decision and therapy.