Correlational study of gall bladder wall thickness using ultrasound and outcomes in laparoscopic cholecystectomy in females

Background: Laparoscopic cholecystectomy is the current gold standard for managing acute cholecystitis and symptomatic gallstone disease, offering faster recovery, shorter hospital stay, and reduced wound morbidity compared to open surgery. Ultrasound is the preferred diagnostic tool for gallstones and biliary dilation, with gallbladder wall thickening frequently noted as a hallmark of acute cholecystitis. Increased wall thickness has been linked to intraoperative difficulties such as hemorrhage, biliary or adjacent organ injury, prolonged dissection time, conversion to open surgery, and extended postoperative recovery. Objective: To evaluate the relationship between gallbladder wall thickness and intraoperative as well as postoperative complications. Materials and Methods: Patients diagnosed with acute cholecystitis by ultrasound and undergoing laparoscopic cholecystectomy at a tertiary care center in South India over 18 months were included. Intraoperative complications (major hemorrhage, biliary or structural injury, prolonged dissection time, conversion to open surgery) and postoperative outcomes (surgical site infection, hospital stay duration) were analyzed in relation to preoperative gallbladder wall thickness. Results: Complication rates were higher in patients with moderately (4–5 mm, 33.4%) and severely (5–6 mm, 53.9%) thickened gallbladder walls compared to mildly thickened (3–4 mm, 30.0%) walls. Postoperative hospital stay was also significantly longer in the moderate and severe groups. Conclusion: Greater gallbladder wall thickness correlates with increased intra- and postoperative complications, higher conversion rates to open surgery, and longer hospital stays.