Usefulness of Ultrasound Findings in Predicting Complications of Acute Cholecystitis

Abstract

Introduction: Acute cholecystitis is considered a clinical and surgical challenge, and its complications increase morbidity and mortality. Ultrasound is used for early diagnosis, although its ability to predict complications has not been comprehensively addressed.

Objective: To evaluate the usefulness of ultrasound findings in predicting complications in patients with acute cholecystitis.

Methods: An observational analytical case-control study was conducted with 250 patients with acute cholecystitis treated at the Guillermo Domínguez López Hospital (2023-2025). Ultrasound and sociodemographic variables were compared between patients with and without complications. Univariate and logistic regression analyses were performed to identify independent predictors.

Results: Significant associations were found between ultrasound findings and complications. Anatomical findings showed a greater association with complications such as double vesicular contour, bile duct dilation and multiple lithiasis. Gallbladder measurements were significantly higher in complicated patients, such as length (102.34 ± 12.1 vs. 88.86 ± 10.4 mm; p < 0.01) and wall thickness ≥ 4.5 mm (sensitivity 76%; OR = 4.13). The multivariate model identified five independent predictors: Murphy's sign (OR = 3.19), multiple lithiasis (OR = 3.85), perivesicular fluid (OR = 5.22), vesicular diameter ≥ 40 mm (OR = 5.05), and parietal thickness ≥ 4 mm (OR = 4.13), with high diagnostic accuracy (AUC = 0.935; accuracy 90.2%; VIF = 1.05-1.24).

Conclusions: The integration of ultrasound variables facilitates the prediction of complications in acute cholecystitis with high sensitivity, which can optimize therapeutic planning and reduce morbidity and mortality.