[Ultrasound selection criteria for laparoscopic cholecystectomy]

Laparoscopic cholecystectomy was carried out in 340 patients in the period November 9, 1990, to November 8, 1991. Preoperatively sonographical selection was in use. Only in 3 cases it was necessary to convert to laparotomy and cholecystectomy (including one elective conversion). 80% of the patients admitted to the hospital with symptomatic gallstones could be treated by laparoscopic technique. There was no injury of the bile ducts. Most relevant criterias for sonographical selection are the following: Thickening of the wall of the gallbladder, diameter and number of the gallstones, position of the fundus of the gallbladder in relation to the caudal margin of the liver, diameter of the common bile duct and exclusion of intraabdominal adhesions by using a high-frequent ultrasound transducer. Sonographical criterias for exclusion are a completely stone-filled gallbladder, a scleroatrophic gallbladder, acute cholecystitis with wall-thickening without edema and extended intraabdominal adhesions in the right upper quadrant. Sensitivity of sonographical selection was 98.5%, specifity 97.6%.