GALLBLADDER WALL THICKNESS AND SURGICAL OUTCOMES IN LAPAROSCOPIC CHOLECYSTECTOMY

Abstract

OBJECTIVE To compare the frequency of adverse outcomes between patients with normal (≤3 mm) and increased (>3 mm) gallbladder wall thickness and to determine whether increased thickness is an independent predictor of these outcomes.

STUDY DESIGN Cohort study

PLACE AND DURATION OF THE STUDY Department of General Surgery, Dr Ziauddin Hospital, Clifton, Karachi, from _______to ________

METHODOLOGY A total of 180 patients aged eighteen years and above with symptomatic gallstone disease scheduled for laparoscopic cholecystectomy were enrolled through consecutive sampling and grouped by gallbladder wall thickness into an exposed (>3 mm) and an unexposed (≤3 mm), then followed for a composite adverse surgical outcome. Data analysis was performed through SPSS- 26 by chi-square, Fisher’s exact test, t-test, Mann-Whitney U test, logistic regression and relative-risk estimation.

RESULTS The mean age was 43.3 ± 12.0 years, and 115 patients (63.9%) were women. An increased wall thickness was present in 55 patients (30.6%). The adverse outcome occurred in 49.1% of the increased group versus 13.6% of the normal group (p < 0.001), with a crude odds ratio of 6.13 (95% CI 2.94–12.78), and a relative risk of 3.61 (95% CI 2.15–6.06).

CONCLUSION GWWT greater than 3 mm was associated with a higher rate of adverse surgical outcomes at laparoscopic cholecystectomy, which remained after adjustment in most subgroups, except for the small diabetic subgroup. Simple and readily available ultrasound of the wall thickness before surgery is a useful predictor of patients who may have a more challenging operation and poor postoperative recovery