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© 2002 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 21:971-976 • 0278-4297

Preoperative Ultrasonographic Assessment of the Number and Size of Gallbladder Stones

Is It a Useful Predictor of Asymptomatic Choledochal Lithiasis?

Renato Costi, MD, Leopoldo Sarli, MD, Giuseppe Caruso, MD, Domenico Iusco, MD, Sara Gobbi, MD, Vincenzo Violi, MD and Luigi Roncoroni, MD

Institute of General Surgery, Parma University School of Medicine, Parma, Italy.

Address correspondence and reprint requests to Renato Costi, MD, Istituto Clinica Chirurgia Generale e Terapia Chirurgica, Azienda Ospedale, Via Gramsci 14, 43100 Parma, Italy.

Objective. To evaluate whether preoperative ultrasonographic assessment of the number and size of gallbladder stones can identify patients at increased risk of having asymptomatic common bile duct stones. Methods. Ultrasonographic data for 300 consecutive patients undergoing laparoscopic cholecystectomy were analyzed. Patients were divided into a group in which multiple small (<=5 mm) or multiple variably sized (both <=5 and >5 mm) gallbladder stones were present ("positive" stones) and a group with multiple large (>5 mm) or single gallbladder stones, considered "negative." The ultrasonographic description was compared with surgical findings; finally, the prevalence of asymptomatic common bile duct stones in the 2 groups was compared. Results. Ultrasonographic classification of gallbladder stones was confirmed at surgery in 285 cases (95%). Asymptomatic common bile duct stones were diagnosed in 9.5% of patients with an ultrasonographic diagnosis of positive gallbladder stones and in only 2.3% of patients with a diagnosis of negative gallbladder stones (P < .05). Conclusions. Ultrasonography is able to accurately show gallbladder stones; the appearance of multiple small and variably sized gallbladder stones represent a risk factor for synchronous asymptomatic common bile duct stones.

Abbreviations: CBDS, common bile duct stones • ERC, endoscopic retrograde cholangiography • GBS, gallbladder stones • LC, laparoscopic cholecystectomy

Key Words: asymptomatic common bile duct stones • number of gallbladder stones • size of gallbladder stones • ultrasonography

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Copyright © 2002 by the American Institute of Ultrasound in Medicine.