Trends in Clinical and Medical Sciences
Special issue: Recent developments of medical and surgical research (2023), pp. 175 – 181
ISSN: 2791-0814 (online) 2791-0806 (Print)
DOI: 10.30538/psrp-tmcs2023.si-rdmsr023
ISSN: 2791-0814 (online) 2791-0806 (Print)
DOI: 10.30538/psrp-tmcs2023.si-rdmsr023
Assessment of pre-operative factors for predicting a difficult laparoscopic cholecystectomy
Neeraj Jain\(^{1}\), Manjari Goel Jain\(^{2}\), Sanish Philips\(^{1}\) and Rinku Yadav\(^{3,*}\)
\(^{1}\) Department of Surgery, Chirayu Medical College, Bhopal M.P. India.
\(^{2}\) Department of Obstetrics and Gynecology, RKDF Medical College, Bhopal M.P. India.
\(^{3}\) Department of Surgery, N.S.C. Govt. Medical College, Khandwa, M.P. India.
Correspondence should be addressed to Rinku Yadav at drrinkugrmc8622@gmail.com
Copyright © 2023 Neeraj Jain, Manjari Goel Jain, Sanish Philips and Rinku Yadav. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: January 5, 2023 – Accepted: April 10, 2023 – Published: April 15, 2023
Abstract
Background: Laparoscopic cholecystectomy (LC) is considerably gold standard for symptomatic cholelithiasis. Preoperative prediction of difficult LC and operative grading system may not only improve patient safety but also be beneficial in lessening the overall cost of therapy.
Aim: The present study aimed to predict and analyze risk factors using a scoring system deemed responsible for surgical difficulties in patients undergoing laparoscopic cholecystectomy (LC) for symptomatic cholelithiasis.
Material & Methods: This hospital based prospective study was conducted at Department of Surgery, A tertiary care teaching Hospital, central India. Various factors considered preoperatively were gender, age, previous history of hospitalization, impacted stone, obesity; gall bladder wall thickness, pericholecystic collection; previous abdominal scar and palpable gall bladder were evaluated.
Results: Out of 150 patients, majority of the (34.2%) was 41-50 years age group, predominantly female (62.7%).The scoring system predicted easy LC for 106(70.7%), and difficult for 44(29.3%). No significant association of difficult LC with age group, gender, BMI, h/o hospitalization with acute cholecystitis, abdominal scar, leucocytes count and Hepatic echotexture (P>0.05), whereas palpable gall bladder, GB wall thickness, Distended gallbladder, impacted stone and pericholecystic collection were significantly associated with difficult LC.
Conclusion: Preoperative prediction of the factors leading to difficulty or conversion in cholecystectomy could help plan the surgical strategies and possible outcomes beforehand which can reduce the overall mortality and morbidity.
Aim: The present study aimed to predict and analyze risk factors using a scoring system deemed responsible for surgical difficulties in patients undergoing laparoscopic cholecystectomy (LC) for symptomatic cholelithiasis.
Material & Methods: This hospital based prospective study was conducted at Department of Surgery, A tertiary care teaching Hospital, central India. Various factors considered preoperatively were gender, age, previous history of hospitalization, impacted stone, obesity; gall bladder wall thickness, pericholecystic collection; previous abdominal scar and palpable gall bladder were evaluated.
Results: Out of 150 patients, majority of the (34.2%) was 41-50 years age group, predominantly female (62.7%).The scoring system predicted easy LC for 106(70.7%), and difficult for 44(29.3%). No significant association of difficult LC with age group, gender, BMI, h/o hospitalization with acute cholecystitis, abdominal scar, leucocytes count and Hepatic echotexture (P>0.05), whereas palpable gall bladder, GB wall thickness, Distended gallbladder, impacted stone and pericholecystic collection were significantly associated with difficult LC.
Conclusion: Preoperative prediction of the factors leading to difficulty or conversion in cholecystectomy could help plan the surgical strategies and possible outcomes beforehand which can reduce the overall mortality and morbidity.
Keywords:
Preoperative scoring system: Gallbladder difficult cholecystectomy; Laparoscopic cholecystectomy.