Non-invasive assessment of destructive changes in the gallbladder and severity of acute cholecystitis

Abstract

Aim . To study the potential of ultrasound examination for assessment of pathomorphological changes in the gallbladder wall according to A1 and A2 criteria and severity of acute cholecystitis (G1-G3 score). Materials and methods . The authors analyzed the results of examination and treatment of 556 patients with acute cholecystitis for the last 2 years. The study involved clinical, laboratory and ultrasound results, their coincidence with the results of histological examination of the removed gallbladder. Results . Clinical and laboratory data coincided with histopathological data in G1 in 84.9% of cases, G2 – in 74.5%, G3 – in 63.2%; ultrasound findings coincided with histopathological data in A1 in 81.54% of cases, in A2 – in 86.59%. The incidence of postoperative complications in G1 comprised 4.6%, in G2 – 8.4%, in G3 – 32.1%, in A1 – 6.8%, and in A2 – 27.7%. Fatal outcomes appeared only in G3 (3.77%) and A2 (2.12%) patients, the overall postoperative mortality was 0.42% and the incidence of postoperative complications was 10.94%. Conclusion . Ultrasound examination in 86.6% of patients with acute cholecystitis enables pathomorphological changes in the gallbladder wall to be evaluated, which significantly facilitates decision making about the timing and extent of surgical intervention.