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.