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. 2019 May;8(5):1678-1684.
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

Mahyar Mohammadifard  1 , Ghodratollah Naseh  2 , Rozita Khatamian Oskooi  3 , Gholamreza Sharifzadeh  4 , Samira Eshraghi  1
Affiliations

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

Mahyar Mohammadifard et al. J Family Med Prim Care. 2019 May.

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.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Distribution of echogenic mass with hemostatic agent use
Figure 2
Figure 2
Frequency distribution of fluid with hemostatic agent use
Figure 3
Figure 3
Comparison of the mean volume of hemostatic agent in the group treated with hemostatic agent immediately and 15, 30, and 45 days after surgery
Figure 4
Figure 4
Comparison of the mean density of hemostatic agent in the group treated with hemostatic agent immediately and 15, 30, and 45 days after surgery with regard to gender
See this image and copyright information in PMC

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