Optimal Period of

Preoperative Hepatobiliary
Ultrasound for Laparoscopic
Cholecystectomy
Primary investigator: K.E. Estaris
Co-author: S.A. Maglangit
Adviser: F. Romancap
Cotabato Regional and Medical Center
Background of the Study
• Laparoscopic cholecystectomy is the gold standard in the treatment of
calculous cholecystitis
• ultrasound is also the best diagnostic tool used to assess the
hepatobiliary system
Background of the Study
• The optimal timing of preoperative ultrasound has not yet been
studied
• beside its additional cost, there has been no evidence nor local study
conducted to support that a repeat ultrasonography should be done
for those with previous ultrasound
• This study aims to have a cost effective preoperative diagnostic
imaging
• This will benefit the patients in CRMC
• This will provide a basis in creating a guidelines in the preoperative
work up of the patients
• As reference for future studies
General Problem
• What is the optimal timing for preoperative hepatobiliary ultrasound?
Objectives
• to determine the optimal timing of preoperative hepatobiliary
ultrasound of patients that will undergo laparoscopic
cholecystectomy.
• To compare the ultrasound findings of the two groups to their
intraoperative findings
• To determine if there is a significant difference between variables
RESEARCH DESIGN
• RETROSPECTIVE COMPARATIVE STUDY
RESPONDENTS
• LC was performed at CRMC from January 1, 2018 to December 31,
2019 .

• had a pre-operative hepatobiliary ultrasound

RESPONDENTS
• (PICTURES OF LAP CHOLE)
INSTRUMENTS
• PATIENTS CHART FROM 2018-2019

• CRMC DEPARTMENT of SURGERY DATA FOR INTRAOPERATIVE

FINDINGS
 INSTRUMENTS
• Checklist of for comparison of ultrasound to intraoperative findings
DATA COLLECTION FORM

Subject Number Hospital Age / Sex

Number
Date Admitted Date of Period of Hepatobiliary Ultrasound
Surgery  
 less than 30 days prior to surgery
 more than 30 days prior to surgery
Pre-operative ultrasound findings
1.Gall bladder wall  non thickened  thickened
2.Gall bladder size  dilated  non dilated
3.number of stones  solitary  multiple
4.CBD size  dilated  non dilated
 dilated  non dilated
Intra-operative findings  
1. Gall bladder wall  normal  thickened
2. Gall bladder size  dilated  non dilated
3 . Number of stones  solitary  multiple
4. CBD size  dilated  non dilated
INSTRUMENTS

• Jamovi statistical software to analyse the data.

Procedure
• Approval
• Collection of medical records
• Data transcription to the checklist
• Collection of intraoperative findings
• Transcription of findings to the checklist
• Coding
• Analysis of the data
Results
• 2 groups
• <30 days
• >30 days
Results

 
Counts % of Total
Frequencies of Pre-op UTZ

Less than 1 month 73 68.9 %

More than 1 month 33 31.1 %

Total 106 100%

     
Results
A. Preoperative ultrasound predictive value- Gall bladder
wall thickness
  GBW Similarity  

Pre-op UTZ YES NO Tot

al

p-value Interpretation
less than one month 52 21 73

0.13 Not significant

more than one month 28 5 33

Total 80 26 106

   
Results
B. Preoperative ultrasound predictive value- Gall bladder
wall distention
  GBD Similarity  

Pre-op UTZ YES NO Tot

al

p-value Interpretation
less than one month 22 51 73

0.22 Not significant

more than one month 14 19 33

Total 36 70 106

   
 C. Preoperative
ultrasound
predictive value- NOS Similarity  

Number of stones
 
Tota
Pre-op UTZ YES NO
l p-value Interpretation
less than one month 47 26 73 0.82 Not significant
more than one month 22 11 33
Total 69 37 106    
D. Preoperative ultrasound
predictive value- Common bile
duct size
  CBD  
Similarity
Pre-op UTZ YE NO T
S o p-
t valu Interpreta
al e tion
less than one month 65 8 7 0.4 Not
3 2 significant
more than one month 31 2 3
3
Total 96 10 1
0
6    
Summary of findings/conclussion
• there is no significant difference between the two
• it is not cost effective to conduct a repeat sonography
• THANK YOU