Relationship Between Gallbladder Wall Thickness and Perioperative Outcomes in Patients Undergoing Laparoscopic Cholecystectomy

IntroductionGallbladder wall thickness is a preoperative imaging parameter.Increased gallbladder wall thickness has been associated with difficult organ dissection, which may influence the postoperative outcome of a patient.The present study aims to understand the relationship between gallbladder wall thickness and intraoperative and postoperative outcomes in patients undergoing laparoscopic cholecystectomy. Materials and methodsThis was a prospective comparative study conducted in the Department of General Surgery and Gastrointestinal Surgery over 18 months.The study began after receiving approval from the institute's ethics committee.Patients with symptomatic cholelithiasis were evaluated preoperatively using ultrasonography to measure gallbladder wall thickness and were subsequently classified into two groups based on their gallbladder wall thickness: Group A (<3 mm) and Group B (≥3 mm).All patients underwent laparoscopic cholecystectomy.Their intraoperative parameters were assessed using an intraoperative difficulty score.Categorical variables between the two groups were compared using the chi-square test and Fisher's exact test where expected cell counts were less, and continuous variables were compared using an unpaired t-test when required. ResultsAfter applying the eligibility criteria, a total of 116 patients were enrolled in the study.Group A (<3 mm) comprised 79 patients (68.10%), and Group B (≥3 mm) comprised 37 patients (31.90%).Age (p=0.28) and gender distribution (p=0.22)showed no statistical significance.Symptom presentation, such as fever, vomiting, and pain radiating to the back, differed significantly between the two groups (p<0.001).Intraoperative difficulty scoring showed that 82.28% (n=65) of participants in Group A were classified as having an easy procedure, followed by a relatively difficult procedure (n=13, 16.46%) and a difficult procedure (n=1, 1.27%).In Group B, a majority had a difficult procedure (n=16, 43.34%), followed by easy procedures (n=12, 32.43%) and relatively difficult procedures (n=9, 24.32%).This difference was statistically significant (p<0.001).Similarly, time to return of bowel sounds was shorter in Group A than in Group B (3.53 ± 2.04 vs 4.93 ± 1.62, p < 0.001), and the duration of hospital stay also differed significantly between the two groups (1.72 ± 0.58 vs 2.54 ± 0.90 days; p<0.001). ConclusionPreoperative gallbladder wall thickness is an important ultrasonography parameter that can be used to assess the intraoperative and postoperative outcomes in patients undergoing laparoscopic cholecystectomy.