Pre-operative prediction of difficult laparoscopic cholecystectomy from clinical, hematological and radiological parameters

Authors

  • Hardik Parmar Department of General Surgery, Medical College and Sir Sayaji General Hospital, Vadodara, Gujarat, India
  • Sahdevsinh Chauhan Department of General Surgery, Medical College and Sir Sayaji General Hospital, Vadodara, Gujarat, India
  • R. Arun Department of General Surgery, Medical College and Sir Sayaji General Hospital, Vadodara, Gujarat, India
  • Akshay Sutaria Department of General Surgery, Medical College and Sir Sayaji General Hospital, Vadodara, Gujarat, India

DOI:

https://doi.org/10.18203/2349-2902.isj20185008

Keywords:

Laparoscopic cholecystectomy, Open cholecystectomy

Abstract

Background: The aim of study was to formulate a scoring system to predict difficult laparoscopic cholecystectomy (LC) pre-operatively; depending on the specific parameters of an individual patient.

Methods: We have included 100 patients who underwent LC from July 2010 to December 2012. Conversion to open cholecystectomy in relation with age, sex, attack of acute cholecystitis, fever, abdominal tenderness, serum amylase and LDH level, status of GB and GB wall thickness, number of stone, leukocyte count and CBD diameter were assessed.

Results: The most important reason for conversion was adhesions at Calot's triangle (60%), followed by contracted gall bladder (15%). The other reasons of conversion were empyema of the gall bladder (15%), stone at Hartmann's pouch (10%), bleeding during dissection (5%).

Conclusions: This study will surely help the surgical fraternity in the future to plan the particular patients for appropriate mode of surgery, pre-operative preparation, patient counselling and most importantly to predict the score for the difficult interval Laparoscopic Cholecystectomy.

References

Beal JM. Historical perspective of gallstone disease. Surg Gynecol Obstet. 1984;158(2):181-9.

Orndoff BH. Theperitoneoscope in diagnosis of the Abdomen. J Radiol. 1;307:1920.

Palmar R. Coelio scopic gynaecologic: Rapportda: professor Moquot:Acad de chair. 1948:72:363.

Kama NA, Kologlu M, Doganay M, Reis E, Atli M, Dolapci M. A risk score for conversion from laparoscopic to open Cholecystectomy. Am J Surg. 2001;181:520-5.

Bulbuller N1, Ilhan YS, Baktir A, Kirkil C, Dogru O. Implementation of a Scoring System for Assessing Difficult Cholecystectomies in a Single Center. Surg Today. 2006;36:37-40.

Liu CL, Fan ST, Lai EC, Lo CM, Chu KM. Factors affecting conversion of laparoscopic cholecystectomy to open surgery. Arch Surg. 1996;131:98-101.

Sanabria JR, Gallinger S, Croxford R, Strasberg SM. Risk factors in elective Laparoscopic Cholecystectomy for conversion to Open Cholecystectomy. J Am Coll Surg. 1994;179:696-704.

Fried GM, Barkun JS, Sigman HH, Joseph L, Clas D, Garzon J, et al. Factors determining conversion to laparotomy in patients undergoing laparoscopic Cholecystectomy. Am J Surg. 1994;167:35-41.

Jansen S, Jorgensen J, Caplehorn J, Hunt D. Preoperative ultrasound to predict conversions in laproscopic cholecystectomy. Surg Laparosc Endosc. 1997;7:121-3.

Brodsky A, Matter I, Sabo E, Cohen A, Abrahamson J, Eldar S. Laparoscopic Cholecystectomy for acute cholecystitis: Can the need for conversion and the probability of complications be predicted? A prospective study. Surg Endosc. 2000;14:755-60.

Bedirli A, Sakrak O, Sozuer EM, Kerek M, Güler I. Factors effecting the complications in the natural history of acute cholecystitis. Hepatogastroenterol. 2001;48:1275-8.

Brunt LM, Quasebarth MA, Dunnegan DL, Soper NJ. Outcome and analysis of Laparoscopic Cholecystectomy in the extremely elderly. Surg Endosc. 2001;15:700.

Hutchinson CH, Traverso LW, Lee FT. Laparoscopic Cholecystectomy. Do preoperative factors predict the need to convert to open? Surg Endosc. 1994;8:875-8.

Teixeira JP, Saraiva AC, Cabral AC, Barros H, Reis JR, Teixeira A. Conversion factors in Laparoscopic Cholecystectomy for acute cholecystitis. Hepatogastroenterol. 2000;47:626-30.

Zisman A, Gold-Deutch R, Zisman E, Negri M, Halpern Z, Lin G, et al. Is male gender a risk factor for conversion of laparoscopic into open cholecystectomy? Surg Endosc. 1996;10:892-4.

Sikora SS, Kumar A, Sexana R, Kapoor VK, Kaushik SP. Laparoscopic cholecystectomy-can conversion be predicted? World J Surg. 1995;19:858-60.

Nachnani J, Supe A. Preoperative prediction of difficult laparoscopic cholecystectomy using clinical and ultrasonography parameters. Indian J Gastroenterol. 2005;24:16-8.

Ibrahim S, Tay KH, Lim SH, Ravintharan T, Chye TN, Chee CH. Risk factors for conversion to open surgery in patients undergoing laparoscopic cholecystectomy. World J Surg. 2006;30:1698-704.

Yol S, Kartal A, Vatansev C, Aksoy F, Toy H. Sex as a factor in conversion from laparoscopic cholecystectomy to open surgery. JSLS. 2006;10(3):359-63.

Alponat A, Kum CK, Koh BC, Rajnakova A, Goh PM. Predictive factors for conversion of laparoscopic cholecystectomy. World J Surg. 1997;21:629-33.

Schrenk P, Woisetschlager R, Reiger R, Wayand WU. A diagnostic score to predict the difficulty of a laparoscopic cholecystectomy from preoperative variables. Surg Endosc. 1998;12:148-50.

Rosen M, Brody F, Ponsky J. Predictive factors for conversion of laparoscopic cholecystectomy. Am J Surg. 2002;184:254-8.

Kanaan SA, Murayama KM, Merriam LT, Dawes LG, Prystowsky JB, Rege RV, et al. Risk factors for conversion of Laparoscopic to open cholecystectomy. J Surg Res. 2002;106:20-4.

Parra Blanco JA, Bueno López J, Madrazo Leal C, Fariñas Alvarez C, Torre Carrasco F, Fariñas MC. Laparoscopic cholecystectomy: analysis of risk factors for predicting conversion to open cholecystectomy. Rev Esp Enferm Dig. 1999;91:359-64.

Tayeb M, Raza A, Khan MR, Azami R. Conversion from laparoscopic to open cholecystectomy: multivariate analysis of preoperative risk factors. J Postgrad Med. 2005;51(1):17-20.

Downloads

Published

2018-11-28

Issue

Section

Original Research Articles