Laparoscopic Versus Transabdominal Ultrasound in Morbidly Obese Patients
Laparoscopic Versus Transabdominal Ultrasound in Morbidly Obese Patients
The objective of this study is to prospectively compare laparoscopic ultrasound to
 transabdominal ultrasound for the detection of gallbladder pathology in obese patients
 presenting for laparoscopic gastric bypass. We hypothesize that laparoscopic ultrasound will
 be more sensitive and specific for cholelithiasis than transabdominal ultrasound in morbidly
 obese patients.
Asymptomatic cholelithiasis is a prevalent condition in obese patients presenting for
 bariatric surgery. Transabdominal ultrasound (TAU) remains the gold standard for detection of
 cholelithiasis. The sensitivity and specificity of transabdominal ultrasound for
 cholelithiasis reported in literature is between 88-97% and 97-99%, respectively. The ability
 to detect cholelithiasis with TAU in the obese population may be inhibited due to the
 presence of increased subcutaneous and visceral fat. Laparoscopic ultrasound (LU) has the
 potential to overcome these technical challenges. In an era of minimally invasive bariatric
 surgery, it has been suggested that routine preoperative ultrasound TAU be performed for the
 detection of cholelithiasis since intraoperative palpation is not feasible. We hypothesize
 that laparoscopic ultrasound will be more sensitive and specific for cholelithiasis than
 transabdominal ultrasound in morbidly obese patients.
Inclusion Criteria:

 -  Morbidly obese patients undergoing elective laparoscopic roux-en-Y gastric bypass

 Exclusion Criteria:

 -  Prior history of gallbladder surgery