A prospective study of preoperative scoring system in predicting difficulty in elective laparoscopic cholecystectomy

Authors

  • Surajit Das Department of Surgery, Government Medical College, Aurangabad, Maharashtra, India
  • Junaid M. Shaikh Department of Surgery, Government Medical College, Aurangabad, Maharashtra, India
  • Rasika V. Jadhav Department of Surgery, Government Medical College, Aurangabad, Maharashtra, India
  • Shubhangi S. Kadam Department of Surgery, Government Medical College, Aurangabad, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-2902.isj20240173

Keywords:

Cholecystectomy laparoscopy, Cholecystitis, Gallbladder

Abstract

Background: Laparoscopic cholecystectomy since its discovery in 1987, has dramatically replaced conventional open cholecystectomy and rapidly became the gold standard for routine gall bladder removal. Today more than 80% of cholecystectomies are carried out laparoscopically. Laparoscopic cholecystectomy although safe and effective, yet poses many difficulties like unclear anatomy, and frozen calots. If risk factors could be reliably identified preoperatively, these factors would aid surgeons in preoperative patient counselling, informed consent, and operative strategy.

Methods: This study conducted over the span of 2.5 years on 66 patients underwent elective laparoscopic cholecystectomy was done to identify risk factors preoperatively and their association with intraoperative difficulty.

Results: Preoperative factors like acute cholecystitis in the past, gall bladder wall thickness and previous history of upper abdominal procedure were fund to be directly related to intraoperative difficulty and laparoscopic to open conversion.

Conclusions: Preoperatively with the help this scoring system we can predict difficulty in laparoscopic cholecystectomy.

References

Calot JF. De la cholecystecomie. Med Frc de Paris. Dissertation. 1891.

Soltes M, Radoňak J. A risk score to predict the difficulty of elective laparoscopic cholecystectomy. Video Surg Other Mini Invasive Tech. 2014;9(4):608-12.

Nidoni R, Udachan TV, Sasnur P, Baloorkar R, Sindgikar V, Narasangi B. Predicting difficult laparoscopic cholecystectomy based on clinicoradiological assessment. JCDR. 2015;9(12):PC09.

Gutt CN, Encke J, Köninger J, Harnoss JC, Weigand K, Kipfmüller K, et al. Acute cholecystitis: early versus delayed cholecystectomy, a multicenter randomized trial (ACDC study, NCT00447304). Ann Surg. 2013;258(3):385-93.

Ercan M, Bostanci EB, Ulas M, Ozer I, Ozogul Y, Seven C, et al. Ef¬fects of previous abdominal surgery incision type on complica¬tions and conversion rate in laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech. 2009;19:373-8.

Seetahal S, Obirieze A, Cornwell EE 3rd, Fullum T, Tran D. Open abdominal surgery: a risk factor for future laparoscopic surgery? Am J Surg. 2015;209:623-6.

Wysong CB, Gorten RJ. Intrahepatic gallbladder. South Med J. 1980.73:825-6.

Nelson PA, Schmitz RL, Perutsea S. Anomalous position of the gallbladder within the falciform ligament. Arch Surg. 1953;66:679.

Szanto I, Voros A, Altorjay A, Kiss J. Gallbladder in the left side of the lower abdomen. Endoscopy. 1997;29:49.

Raman SR, Moradi D, Samaan BM, Chaudhry US, Nagpal K, Cosgrove JM, Farkas DT. The degree of gallbladder wall thickness and its impact on outcomes after laparoscopic cholecystectomy. Surg Endosc. 2012;26(11):3174-9.

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Published

2024-01-30

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Section

Original Research Articles