Laparoscopic cholecystectomy: Evaluation with sonography

To determine the normal postoperative appearance of gallstones in the common duct at ultrasound (US) exunination, the significance of fluid collections after surgery, and the usefulness of routine postoperative scanning, US of the right upper quadrant was performed in 106 consecutive patients 24 hours after laparoscopic cholecystectomy. The location, volume, and appearance of fluid collections were recorded. The maximum diameter of the common duct was measured in all patients and compared with preoperative measurements in 58 patients. Small fluid collections were identified in the gallbladder fossa in 56 patients (53.0%). Fluid collections did not correlate with fever or white blood cell count. In 15 of 58 patients, the diameter of the common duct had increased on the postoperative scan. This did not correlate with alkaline phosphatase or bilirubin levels. One hundred one patients (95.3%) were discharged the day after surgery. Routine US performed the day after surgery did not alter management; the authors conclude that it is unwarranted in their group of patients.