Ghulam Qadir Buledi, Amjad Siraj Memon, Noshad A Shaikh, Ashfaq Ahmed Bhutto.
Role of ultrasound in predicting conversion from Laparoscopic to open Cholecystectomy, a Surgeon`s & Radiologist`s dilemma!.
Med Channel Jan ;12(4):38-41.

This prospective study was jointly conducted by the Department of Radiology and Surgical Ward-II, Dow Medical College & Civil Hospital, Karachi from August 2000 to June 2002: 100 patients were selected for this study and all were admitted with complaints of pain in right hypochondrium / epigastrium, dyspepsia, nausea, vomiting and complained of pain in right shoulder. Provisional diagnosis was made on history and clinical examination as cholecystitis. The ages were between 35 to 60 years. 78 patients were female and 22 patients were male. The aim of this study was to assess the role of pre-operative ultrasound findings with operative findings in patients undergoing laparoscopic cholecystectomy. The purpose was to get the proper diagnosis and provide detailed information to the surgeons before operation about the status of liver, Gall Bladder, C.B.D, Biliary Channels, and specially adhesions between the Gall Bladder and the surrounding structures like Omentun, Duodenum etc. In this way, the surgeon was informed about the findings before operation for successful laparoscopic cholecystectomy to avoid the complications of open surgery. Ultrasound is readily available, inexpensive and the modality of choice in the diagnosis of hepato-biliary disease. Out of 100 patients, 74 patients were selected for laparoscopic cholecystectomy (USG findings showed no adhesions). While 65 patients successfully underwent laparoscopic cholecystectomy, 9 patiems were converted to open cholecystectomy due to unavoidable conditions like inseparable adhesions with surrounding structures (Omentum and Duodenum). Out of the 26 patients selected for open cholecystectomy (USG showed adhesions) due to cholelithiasis and chronic cholecystitis associated with choledocholithiasis, 3 were found to be without adhesions.

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