Abstract :
Background: The evolution of biliary tract imaging for cholelithiasis and its complications has witnessed profound changes in recent decades. Ultrasonography (USG), serum bilirubin and Histopathology stands out as the methods for detecting cholelithiasis and cholecystitis. Thus, we aimed to assess the histopathological correlation with ultrasonography and serum bilirubin in diagnosis of gallbladder pathology.
Materials and Methods: We conducted a cross-sectional study involving 104 patients who underwent USG abdomen scans and Histopathology assessments. Clinico-demographics were recorded along with the serum bilirubin levels. Data was systematically collected and recorded on a custom-designed data sheet. Statistical analysis was subsequently performed to evaluate the gathered information.
Results: In the study of 104 patients, cholecystitis (23 cases) and Cholelithiasis (81 cases) were prevalent, with cholecystitis mainly seen in ages 31-40 (52.17%) and cholelithiasis in ages 41-50 (45.68%). Females predominated. Symptoms included dyspepsia (26.09%) and epigastric pain (26.09%) for cholecystitis, while Cholelithiasis patients had nausea/vomiting (24.69%) and epigastric pain (24.69%). In patients with cholelithiasis, majority had normal levels (39.51%), followed by abnormal levels of 1.3-2.4 mg/dl - 33.33% and level >2.4 mg/dl- 27.16%. The kappa agreement coefficient analysis between USG and HPA had a value of 0.920 whereas it was 0.895 between serum bilirubin and HPA – signifying almost perfect agreement.
3 cases of cholelithiasis were missed on USG but were found intraoperatively and confirmed on HPE. This indicates nearby correlation of HPE with USG and S. Bilirubin independently for cholecystitis and cholelithiasis respectively. Apart from USG or serum bilirubin alone, USG and serum bilirubin achieved Kappa value of 1.000 highlights a strong consistency between histopathology for both conditions.
Conclusion: USG and serum bilirubin, a combinatorial marker approach, is a versatile tool for quick decision-making and intervention guidance in biliary tract cases.
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