Occupational gallbladder lesions include gallbladder polyps, gallbladder cancer, gallbladder adenomyosis, gallbladder adenoma, and other related diseases. In order to improve inpatient bed utilization, effectively utilize medical resources, and reduce patient hospitalization costs while maximizing patient convenience, relevant tests in the perioperative period of LC must be quick and effective. Ultrasound is a commonly used imaging technique in the diagnosis and differential diagnosis of gallbladder diseases. Although gallbladder-occupying lesions have certain characteristics on ultrasound images, conventional two-dimensional ultrasound is still very difficult in the differential diagnosis of different pathological types and morphologically very close lesions. Contrast-enhanced ultrasonography (CEUS) is a new ultrasonographic technique that has been applied to gallbladder-occupying lesions in recent years. The purpose of this paper is to discuss the value of ultrasonography in the perioperative period of laparoscopic cholecystectomy for gallbladder-occupying lesions. I. General data The 50 patients in this group were patients with gallbladder-occupying lesions who underwent laparoscopic cholecystectomy in our hospital from January 2010 to January 2012. There were 31 males and 19 females, with a male-to-female ratio of 1.63:1, aged 22-78 years, with an average of 47.9±12.2 years. II. Ultrasonography method The instrument used was PhilipsIU22 color Doppler ultrasonograph with C5-1 probe, frequency 1.0~5.0MHz, and ultrasonography was performed by low mechanical index pulse inversion (PI) and energy modulation (PM) techniques with mechanical index (MI) of The ultrasound contrast agent was SonoVue (Bracco, Italy), the main component of which was sulfur hexafluoride (SF6) microbubbles with an average diameter of 2.5 μm and a pH of 4.5-7.5. After routine fasting ultrasonography, the contrast agent was injected and the enhancement of the gallbladder and the lesion was observed dynamically for 5 min with reference to the normal gallbladder wall and the surrounding liver parenchyma. After the contrast was injected, the enhancement of the gallbladder and the lesion was observed dynamically for 5 min with reference to the normal gallbladder wall and the surrounding liver parenchyma. Before laparoscopic cholecystectomy, ultrasonography of the gallbladder is routinely performed, and for patients suspected of cancer, laparoscopic exploration is performed first, and radical cholecystectomy with LC or intermediate laparotomy is selected according to the results of the exploration. Prophylactic antibiotics were given 30 min before surgery, one intravenous drip of antibiotics was given after surgery, 2 h of activity on the floor, 4 h of fluid, and 12 h of observation before discharge. Discharge criteria: patients’ vital signs were stable; no obvious abdominal pain; they could get out of bed on their own; no obvious wound bleeding and pain; no obvious nausea and vomiting, and they could eat semi-liquid food; no abnormalities such as fluid accumulation in the abdomen on ultrasonography; body temperature did not exceed 37.5℃. The patients were followed up by telephone every day after discharge until 5 d postoperatively. Results All patients completed the surgery successfully, and 2 cases of gallbladder cancer were referred to open abdomen. the operation time of LC ranged from 14 to 45 min. 2 h after surgery, the patients started to move on the ground, and the recovery time of intestinal function ranged from 2 to 12 h. The average hospitalization time was 2.96±1.33 d. The postoperative pathological results of 50 patients were: 3 cases of gallbladder cancer and 47 cases of benign gallbladder occupying lesions. Among them, cholesterol polyp, gallbladder adenoma, gallbladder adenomyosis and chronic cholecystitis with lymphatic follicular hyperplasia accounted for 72.34% (34/47), 6.38% (3/47), 21.28% (10/47) and 4.26% (2/47) of benign lesions, respectively, and two patients had both cholesterol polyp and gallbladder adenoma. The diagnostic accuracy of ultrasonography for benign lesions and pathology was 100% (46/46), and the diagnostic accuracy for gallbladder cancer was 75% (3/4). In the diagnosis of benign occupying lesions, the diagnostic accuracy of ultrasonography was 100% (3/3), 92.86% (13/14) and 25% (2/8) for gallbladder adenomatosis, cholesterol polyps and gallbladder adenoma, respectively. Discussion In developed countries, laparoscopic cholecystectomy can already be performed in outpatient operating rooms, clinics or separate wards in hospitals, and day surgery specialist wards are increasingly being used for laparoscopic cholecystectomy in China. In order to improve the utilization of inpatient beds, effective use of medical resources and reduce the cost of hospitalization for patients. At the same time it can maximize patient convenience, perioperative related investigations must be quick and effective. Although gallbladder polyp-like lesions have certain characteristics on ultrasound images, they lack specificity, such as broad-based solitary gallbladder polyps, early thick-walled gallbladder carcinoma, limited adenomyomatous hyperplasia of the gallbladder, and biliary sludge deposition disease that does not change with body position, for which conventional two-dimensional ultrasound still has difficulties in differential diagnosis. Ultrasonography has become a fast and convenient imaging method with accurate and reliable results because it can display the blood flow signal in the lesion in real time. In this study, I observed that ultrasonography of gallbladder cancer often showed heterogeneous hypoechoic nodules in the wall or lumen of the gallbladder, with rapid hyperenhancement of the lesions in the arterial phase, poor distribution, and multiple irregular vascular structures, poor continuity of the gallbladder wall structures at the attachment of the lesions, and disappearance of normal structures. The ultrasonography of gallbladder polyps often shows that the arterial phase and delayed phase are always isoenhanced with the gallbladder wall or slightly above it. Ultrasonography of adenomatous hyperplasia of the gallbladder shows a limited thickening of the gallbladder wall, which is seen to enhance synchronously with the wall in the arterial phase, in a circular pattern, where the wall structure is continuous and intact. Our results also showed a high accuracy of ultrasonography in the diagnosis of benign and malignant gallbladder-occupying lesions. Cholesterol polyps accounted for the largest proportion of benign occupying lesions of the gallbladder. The diagnostic accuracy of ultrasonography for cholesterol polyps and gallbladder adenomatous hyperplasia was high, but the diagnostic accuracy for gallbladder adenoma was low, and it was most often misdiagnosed as cholesterol polyps. In conclusion, ultrasonography has a high diagnostic accuracy for gallbladder space-occupying lesions, which can significantly shorten the waiting time for relevant tests before LC surgery and provide more reliable diagnostic information for clinical practice. However, further studies are needed to distinguish the pathological typing of gallbladder polyps, special types of gallbladder polyps, gallbladder adenoma and gallbladder cancer by ultrasonography.