Utility of routine ultrasound after laparoscopic cholecystectomy to detect early postoperative complication

In up to 3% of laparoscopic cholecystectomies, procedure-related complications occur. Routine postoperative ultrasound is one means of screening for these complications. The aim of this study was to determine the utility of this practice after laparoscopic cholecystectomy.

A series of consecutive patients (n = 1,044) undergoing laparoscopic cholecystectomy from January 2007 to January 2011 was analysed. Primary endpoint was the detection of procedure-related complications by routine ultrasound.

Routine ultrasound within the first 48 h after laparoscopic cholecystectomy was performed in 967 of 1,044 patients. Overall, 25 (2.4%) of the 1,044 patients suffered from procedure-related complications, but only in 2 patients was the complication detected by routine ultrasound. Findings were false-positive in 103 patients. This corresponds to a sensitivity of 8% and a specificity of 89%. Hospital stay was prolonged in the false-positive group.

Routine postoperative ultrasound has a low sensitivity for the detection of complications after laparoscopic cholecystectomy. In almost all cases, the diagnosis is initiated by clinical findings. Therefore, routine ultrasound is of limited value in screening for postoperative complications after cholecystectomy.