Comparison of the sonographic findings in laparoscopic cholecystostomy with and without hemostatic agent on 45-day follow-up of patients attending hospital

Mahyar Mohammadifard; Ghodratollah Naseh; Rozita Khatamian Oskooi; Gholamreza Sharifzadeh; Samira Eshraghi

doi:10.4103/jfmpc.jfmpc_92_19

Comparison of the sonographic findings in laparoscopic cholecystostomy with and without hemostatic agent on 45-day follow-up of patients attending hospital

J Family Med Prim Care. 2019 May;8(5):1678-1684. doi: 10.4103/jfmpc.jfmpc_92_19.

Authors

Mahyar Mohammadifard¹, Ghodratollah Naseh², Rozita Khatamian Oskooi³, Gholamreza Sharifzadeh⁴, Samira Eshraghi¹

Affiliations

¹ Department of Radiology, Birjand University of Medical Sciences, Birjand, Iran.
² Department of Surgery, Birjand University of Medical Sciences, Birjand, Iran.
³ Department of Emergency Medicine, Imam Reza Hospital, Birjand University of Medical Sciences, Birjand, Iran.
⁴ Department of Statistics, Birjand University of Medical Sciences, Birjand, Iran.

Abstract

Introduction: Cholelithiasis is one of the most prevalent pathological conditions, and elective laparoscopic cholecystostomy with and without hemostatic agent (HA) is the therapeutic approach to its treatment. This research study aimed to compare the sonographic findings of patients who underwent cholecystostomy with and without HA use.

Materials and methods: This cross-sectional, descriptive-analysis study was conducted by available nonprobability sampling technique, and according to Cochran Formula, 144 patients, who underwent laparoscopic cholecystostomy, were recruited and divided into two groups including a group of 85 patients with HA use and a group of 59 patients without HA use. Patients in each group had sonography on discharge date and 15, 30, and 45 days after the surgery. Data were collected and entered in SPSS-24 software; meanwhile, descriptive statistics was used to analyze Chi-square test, Fisher's exact test, and Friedman and Wilcoxon nonparametric test.

Findings: The results of the study showed that the presence of echogenic mass with reverberation artifact (abscess mucosa) on 15- and 30-day follow-up sonography of patients, who underwent laparoscopic cholecystostomy, were significantly higher in patients with HA than in the group without HA (P < 0.05), and on 45-day follow-up sonography, there was no significant correlation regarding the presence of echogenic mass with reverberation artifact (abscess mucosa) and fluid in the two groups (P > 0.05). Besides, HA density significantly decreases in individuals over time (P < 0.05); however, there was no significant differences between HA reduction rate and gender (P > 0.05).

Conclusion: These findings might be the indication of HA agents' effect on surgical operations and their resemblance to abscess. Due to the possibility of temporary immune responses to HA, as an external object, it is necessary, in vital pathologies, to pay close attention to what differentiates the normal imaging appearance in follow-up sonography.

Keywords: Cholecystostomy; hemostatic agent; sonography.