ULTRASONOGRAPHIC ANALYSIS IN CHOLELITHIASIS TO EVALUATE ITS IMPACT IN DIAGNOSIS, TREATMENT AND GALL STONE COMPOSITION

Dr. Urvil A. Shah* and Dr. Anil K. Shah

ABSTRACT

Introduction: Lifestyle and dietary habits of the patient are the most influencial factors for the formation of gall stones. Gallstones constitute a significant health problem in developed countries, affecting 10% to 15% of the adult population. In India prevalence of gall stones is 10 -20 %. Gallstones are common in the female population as compared to males. Formation of gallstones is due to inadequate physical activity, high waist hip ratio and excessive intake of saturated fats. Cholelithiasis is sometimes diagnosed in patients incidentally or as silent stones. Also they are reported in association with clinical symptoms such as cholecystitis and cholangitis. Ultrasound is the method having best sensitivity and specificity for evaluating patients with suspected gallstones. Material and Methods: The present study was carried out in the department of Radiology CCM Medical College and Hospital Kachandur, Durg. Total 150 patients were included in the study who were diagnosed of cholelithiasis. All patients underwent ultrasound examination prior to their surgery and histopathological analysis of gallbladder postoperatively. The gall stone was taken out and was further examined for bilirubin, calcium, cholesterol and phosphate. Results: 133 were positive for gallstones and 17 negative for gallstones. Out of 133 positive for gall stones 129 were confirmed by histopathology and 4 were found to have no gallstones on histopathology. Of the 17 ultrasound scans found to be negative for gallstone, no subsequent gallstones found on histopathology. As compared to histopathological reports sensitivity of ultrasonography was 100% (95% CI 97.18% to 100.00%). Specificity was 80.95 %( 58.09% to 94.55%). Positive Predictive Value 96.99 %( 95% CI 93.03% to 98.73%) and negative Predictive Value was 100.00 %. Accuracy of ultrasonography was 97.33% (95% CI 93.31% to 99.27%).Of the total histologically confirmed gallstones 20(15.03%) were cholesterol stone, 96 (74.04%) were mixed stone, while 13(10.34%) were pigment stone, Conclusion: Ultrasonography is accurate in diagnosing cholelithiasis and is considered the preferred initial imaging technique for patients who are suspected of having acute calculous cholecystitis.

Keywords: Ultrasound, gall stones.