Ultrasonographic Evaluation of Gallbladder Diseases: An Original Study.

Introduction: The diagnostic accuracy for the diseases of the gall bladder is high for the Ultrasound. Hence, in the present study, we aimed to evaluate the application of the ultrasound as a major diagnostic aid for the gallbladder diseases. Materials and
Methods: We piloted observational study among 100 patients with gallbladder diseases. The clinical, ultrasonograhic, and the histopathological parameters were compared to check the validity of the tests using t-test deliberating P < 0.05 as significant.
Results: We observed that number of the cases that were positively identified radiographically were 93 out of 82 actual cases and 67 identified by the Fine Needle Aspiration Cytology (FNAC). There was no significant difference between the clinical, pathological diagnosis and the ultrasonograhic diagnosis indicating a accuracy similar to the clinical and FNAC methods.
Conclusion: Ultrasonograhic diagnosis performed similar to the other forms of diagnosis and can be suggested as a convenient and accurate diagnostic test for the diseases of gallbladder. Copyright:

INTRODUCTION

The gall bladder pathologies are common in the developed countries with a significant incidence among middle aged women. The occurrence of these pathologies varies greatly among the sexes, ages, and the ethnicities.[123] Ultrasound imaging is one of the most easily accessible and economic diagnostic methods that can be used for the diagnosis of these common pathologies. The diagnostic accuracy of this health aid was found to satisfy among various other pathologies. Since the gall bladder diseases are on a raise among the nations due to the change of the life style, the application of the ultrasound may be of great implications.[456] Hence, in the present study, we aimed to evaluate the application of the ultrasound as a major diagnostic aid for the gallbladder diseases.

MATERIALS AND METHODS

We piloted a prospective observational study among 100 patients who were symptomatic of the gall bladder diseases. The study was conducted for a period of 2 years after the ethical clearance was obtained. The written consent was taken from the patients. The subjects who had any other medical conditions, recent surgeries, and unwilling to participate were excluded from the study. The patients were evaluated for the clinical parameters initially and later were imaged for the ultrasonograhic presentations. The FNAC was performed for the patients after imaging. The data were collected for the demographics and analyzed using IBM SPSS ver. 20. The comparison of the three parameters was done using the t-test deliberating P < 0.05 as significant.

RESULTS

We observed that among the 100 patients, there was no significant variation for the genders while majority were women. The mean age was 48 ± 6.8 years. The number of the cases that were given a final diagnosis of the gall bladder disease was 90. The distribution of the age groups was not significant as well. We observed that the most common disease was chronic cholecystitis. There was a greater accuracy in the diagnosis of the gall bladder diseases in the ultrasound imaging than the clinical and the variation was not significant. Similarly, when the radiographic and the FNAC approaches were tested, the ultrasonography performed similar to the FNAC, and the variation was not significant. However, the diagnostic accuracy was of great difference when the chronic cholecystitis was deliberated [Table 1].

Table 1

Comparison of various diagnostic approaches for the gallbladder diseases

Demographics	n	n	P
Gender	Male - 41	Female - 59	0.81
Age	48±6.8		-
Final diagnosis of the GBD	90
Condition	Clinical	Radiological	P
Gallstone (82)	43	92	0.55
Acutecholecystitis (10)	12	14
Chroniccholecystitis (62)	10	59
Others (10)	3	3
Condition	Radiology	Pathology	P
Gallstone (82)	92	67	0.45
Acutecholecystitis (10)	14	12
Chroniccholecystitis (62)	59	15
Carcinoma (5)	3	5

DISCUSSION

Gallbladder pathologies are extremely frequent, with a wide range of pathological, radiological, and clinical manifestations, with a considerable amount of mortality and morbidity. It denotes a change in hepato-biliary function. The majority of gallbladder pathologies are caused by gallstones, which account for around 95% of all gallbladder diseases, with non-calculus disease accounting for approximately 5%. Gallbladder inflammations, either acute or chronic, are frequent in patients with calculus gallbladders. Benign neoplasms are extremely rare. Inflammatory conditions are frequent than the malignant and benign. In our study, majority of the patients were middle aged women which is similar to the findings of Shabanzadeh et al.[5] Our findings suggest that majority of the patients had gallstones. Only less than 10% were non-calculus patients. There were few cases of the carcinoma that were diagnosed ultrasonographically similar to the FNAC. In our study, chronic cases were four times more prevalent than the acute cholecystitis. And consistent with the previous studies, the chronic cases of the cholecystitis, carcinoma cases were prevalent in the study.[567]

The limitation of our study was that the blinding of the investigators was not done. The classification of the gall stones was also not considered for the study.

CONCLUSION

Within the limitations of this study, we can suggest that the ultrasound can be used for the diagnosis of the gall bladder disease. This diagnostic aid is economic, fast, easily available, and less technique sensitive compared to other complex diagnostic aids. Further studies are suggested to corroborate our findings.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.