Objective: To determine the accuracy of ultrasound in detecting pathology of the biliary tract and also to know different biliary anomalies detected by ultrasound and compare this with operative findings.

Methodology: This observational cross-sectional study was conducted at the General surgery department of Liaquat University of Medical and Health Sciences, one year after approval of proposal. Patients underwent biliary surgeries following ultrasound findings, with biliary pathology, of both gender and aged >15 years were included. Applicable treatment was employed which involved operative intervention. The data along with ultrasound of the abdomen and Operative findings were recorded on a proforma. Results were formulated using SPSS 20.

Results: Out of 100 patients, male and female patients were 13% and 87% respectively. The mean age was 42.0±6.4 years. 90% of patients had epigastrium pain, 40% of patients had anorexia, 35% had vomiting and nausea, 25% had fatigue and 16% had fever. Laparoscopic cholecystectomy was performed in 60% of patients, while 40% of patients experienced open surgery. A single stone was recorded in 22% of cases. On ultrasound, 68% of cases were found to have multiple calculi in the Gallbladder. Although, a total of 100(100%) cases underwent surgical procedure and 70% of the patients, following surgical intervention, were found to have multiple calculi. Notably, operated cases were found to have a significantly lesser frequency of acalculus cholecystitis than those of the ultrasound findings (p-value 0.04). However, no significant variance was observed between operative and ultrasound findings in patients with chronic cholecystitis, CBD stone, benign polyp and gall bladder perforation.

Conclusion: It is concluded that ultrasonography contributes significantly as an initial screening technique for the detection of gallbladder/biliary pathology, with significant benefits such as easy accessibility, low costs, no contrast material needed and no ionizing radiation.