Ultrasound evaluation of cholelithiasis in the morbidly obese

The ability to detect gallstones in the morbidly obese population has been questioned in recent literature. Utilizing state-of-the-art, real-time ultrasound equipment, 44 morbidly obese patients were examined prior to gastric exclusion surgery and concomitant cholecystectomy. The 91% sensitivity and 100% specificity of gallstone detection in this series matches the results for the general population. This study provided the unique opportunity to evaluate a large number (34) of negative ultrasound examinations, with subsequent surgical confirmation yielding a negative predictive value of 97%. This confirms the continued role of ultrasound in the evaluation of cholelithiasis.