Gallbladder wall thickness adversely impacts the surgical outcome

Area of Science:

• Gastroenterology
• Surgical Outcomes
• Diagnostic Imaging

Background:

• Gallbladder wall thickness (GBWT) is a sonographic finding that may indicate underlying gallbladder pathology.
• Evaluating the clinical significance of GBWT > 5 mm in patients undergoing cholecystectomy is crucial for surgical planning and risk assessment.

Purpose of the Study:

• To assess and compare the surgical outcomes of patients who underwent cholecystectomy, stratified by gallbladder wall thickness (GBWT) status.
• To identify factors associated with increased length of hospital stay in patients with thickened gallbladder walls.

Main Methods:

• Retrospective analysis of 1,211 patients who underwent cholecystectomy.
• Classification into two groups: GBWT+ (thickness > 5 mm) and GBWT- (thickness ≤ 5 mm).
• Comparison of demographic, clinical, laboratory, and ultrasound findings, as well as surgical outcomes between the two groups.

Main Results:

• 14.6% of patients had GBWT+; these patients were older, had more comorbidities (higher ASA score), and presented with more complicated gallstone disease (larger stones, CBD stones, biliary pancreatitis).
• GBWT+ group experienced significantly more urgent surgeries, higher conversion rates, prolonged operative times, increased bleeding, and greater need for postoperative drains.
• Multivariate analysis identified GBWT+ (OR: 1.97), urgent surgery, prolonged operation, and postoperative drain as independent predictors of extended hospital stay.

Conclusions:

• Gallbladder wall thickness ≥ 5 mm is an independent predictor of extended hospital stay following cholecystectomy.
• Patients with GBWT+ are at increased risk for complications and prolonged hospitalization compared to those with normal GBWT.