Routine Gallbladder Ultrasonography Before Gastric Restrictive Bariatric Surgery: is it worthwhile?

Gallbladder ultrasonography is frequently included In the pre-operative evaluation of bariatric surgical patients. A study was conducted to evaluate the cost-benefit relationship of these studies. Sonographies were performed in 101 patients before their stapling procedure. The results were not made known to the surgeon until after he had decided on the basis of findings at surgery whether to remove or leave the gallbladder. In 92 of the 101 patients the radiologist was willing to read the study as normal or abnormal; in nine patients the study was felt to be indeterminate. There was one false positive sonogram, and one picked up a lesion missed clinically. In one case stones were palpable at surgery but missed by sonogram. Forty-three patients had no stones by either criterion but had visible cholesterolosis, etc., and their gallbladders were removed. The results suggest that in this group of patients the expense of routine preoperative sonography may not be justified.