Association between Gallbladder Wall Thickness and Surgical Outcomes Following Laparoscopic Cholecstectomy in Patients with Gall Stone Disease: A Prospective Observational Study

Introduction: Gallstone disease is a prevalent gastrointestinal disorder, often managed surgically via Laparoscopic Cholecystectomy (LC), which is considered the current gold standard. However, Gallbladder Wall Thickness (GBWT), assessed preoperatively using ultrasonography, is known to influence the complexity and outcomes of LC. Increased GBWT may predict intraoperative challenges and postoperative complications, but standardised risk stratification based on GBWT remains underutilised. Aim: To evaluate the association between GBWT and intraoperative as well as postoperative outcomes in patients undergoing LC for symptomatic gallstone disease. Materials and Methods: This prospective observational study was conducted at the Department of General Surgery, SRM Medical College Hospital and Research, Chennai, Tamil Nadu, India from March 2024 to March 2025. included 137 patients undergoing LC. Preoperative GBWT was measured using ultrasonography and patients were stratified into four groups: normal (≤2 mm), mildly thickened (>2-4 mm), moderately thickened (>4-6 mm), and severely thickened (>6 mm). Intraoperative parameters (surgery duration, bleeding, bile duct injury, conversion to open surgery ) and postoperative outcomes (bile leak, wound infection, ileus, hospital stay) were assessed. Appropriate statistical tool *chi-square test for categorical variables and Analysis of Variance (ANOVA) or t-test for continuous variables were used. Results: The mean age of the participants was 46.5±12.7 years. Increasing GBWT was significantly associated with longer operative time, higher conversion rates, increased intraoperative bleeding, and higher rates of bile duct injury, bile leak, wound infection, and prolonged ileus. Mean hospital stay also rose progressively with GBWT, reaching 14±5.7 days in the severely thickened group. Conclusion: The GBWT is a reliable, non invasive preoperative predictor of surgical difficulty and complications in LC. Incorporating GBWT-based stratification can optimise surgical planning and improve patient outcomes.