Our objective is to evaluate the influence of histological alterations in lithiasic gallbladders in the diagnosis and laparoscopic treatment of this disease. From January 1994 to May 1997, 290 patients were submitted to videolaparoscopic cholecystectomy. The morphological alterations observed in lithiasic gallbladders were evaluated by histological study and were compared with lhe pre-operative exams and surgical findings. The gallbladders were classified, by histological study, in chronic cholecystitis in 71.7% and in acute cholecystitis in 13.1% of cases. There were no histological alterations in 15.7%, classified as normal gallbladders. Acute cholecystitis predominated in mate patients (31.6%). Ultrasound had low sensibility in the diagnosis of acute cholecystitis (36.8%). All patients with normal gallbladders were operated by laparoscopy. In 21.1% of the acute cholecystitis it was necessary to convert to open surgery. The gallbladders with chronic cholecystitis were associated with mixed stones in a statistically significant manner: We showed a low sensibility of ultra-sound in the diagnosis of acute cholecystitis and the high effectiveness of laparoscopy in the treatment of patients with gallbladder stones without histological alterations.
Gallbladder; Cholelithiasis; Ultrasound; Laparoscopy