STUDY OF PREOPERATIVE CLINICAL AND INVESTIGATIVE FACTORS PREDICTING DIFFICULT LAPAROSCOPIC CHOLECYSTECTOMY
DOI:
https://doi.org/10.29121/granthaalayah.v8.i3.2020.144Keywords:
Prediction, Difficult, Laparoscopic CholecystectomyAbstract [English]
Background: Laparoscopic cholecystectomy is one of the most commonly performed surgical procedure with the advantage of short hospital stay, cosmetic, less post-operative pain and early return to work and thus ultimately cost effective. However, certain factors can make the procedure difficult and such patients many do not enjoy benefit of laparoscopic procedure particularly longer hospital stay.
Aim: To determine various factors on clinical, pathological and radiological grounds to predict difficult laparoscopic cholecystectomy.
Material and Method: 200 patients admitted in surgical ward with a diagnosis of Chronic Calculus cholecystitis to be selected for laparoscopic cholecystectomy were subject of this study. Age, Sex, BMI, number of previous attack, previous abdominal surgery, past history of pancreatitis and jaundice, signs of acute cholecystitis, leucocytosis, CRP, Liver function tests, serum amylase and lipase, GB wall thickness, presence of pericholecystic fluid , status of GB and anatomical variation were various factors studied.
Results: Age > 50 years, male sex, BMI>30, more than 4 attacks, signs of cholecystitis, leucocytosis > 11,000/cu mm, increased GB wall thickness, presence of pericholecystic fluid and overdistended or contracted gall bladder are associated with difficult laparoscopic cholecystectomy.
Downloads
References
Tendon, R. “Diseases of gallbladder and biliary tract”. API text book of medicine, Dr. Siddarth N Shah, 2003; 7th edition: Pp. 642-44.
Conference NC.: Gallstones and laparoscopic cholecystectomy. JAMA. 1992;269:1018-24.
Sharma SK, Thapa PB, Pandey A, Kayestha B, Poudyal S.: Predicting difficulties during laparoscopic cholecystectomy by preoperative ultrasound. Kathmandu University Medical journal. 2007;5(17):8-11.
Russell JC, Walsh SJ, Reed-Fourquet L, Mattie A, Lynch J.: Symptomatic cholelithiasis: A Different disease in men? Ann Surg. 1998;227:195–200. DOI: https://doi.org/10.1097/00000658-199802000-00007
Randhawa JS, Pujahari AK. Preoperative prediction of difficult lap chole: A scoring method. Indian J Surg.2009;71:198–201. DOI: https://doi.org/10.1007/s12262-009-0055-y
Prashant KD, Subodh P Ugane.: Factors predicting difficult laparoscopic cholecystectomy: A single-institution experience.Year 2014, Vol.-4, Issue-1, pages 3-7 DOI: https://doi.org/10.4103/2230-7095.137612
Nachnani, J, Supe A: Pre-operative prediction of difficult laparoscopic cholecystectomy using clinical and ultrasonographic parameters.. Ind J Gastroenterology 2005 Vol 24 January - February
Hussien M, Appadurai IR, Delicata RJ, Carey PD.: Laparoscopic cholecystectomy in the grossly obese: 4 years experience and review of literature. HPB (Oxford)2002;4:157–61. DOI: https://doi.org/10.1080/13651820260503792
Alponat A, Kum CK, Koh BC, Rajnakova A, Goh PM.: Predictive factors for conversion of laparoscopic cholecystectomy. World J Surg. 1997;21:629–33. DOI: https://doi.org/10.1007/PL00012288
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 Jun; 181(6):520–5. DOI: https://doi.org/10.1016/S0002-9610(01)00633-X
Vivek, MAKM, Augustine, AJ and Rao.R : A comprehensive predictive scoring method for difficult laparoscopic cholecystectomy J Minim Access Surg. 2014 Apr-Jun; 10(2): 62–67 DOI: https://doi.org/10.4103/0972-9941.129947
Nidoni R, Udachan TV, Sasnur P et al: Predicting difficult laparoscopic cholecystectomy based on clinicoradiological assessment. J.Clin Diagn Res, 2015, Dec:9(12);PC-09-PC-12 DOI: https://doi.org/10.7860/JCDR/2015/15593.6929
Singh K, Ohri A. Difficult laparoscopic cholecystectomy: A large series from north India. Indian J Surg 2006;68:205-8
Lal P, Agarwal PN, Malik VK, Chakravarti AL. A difficult Laparoscopic cholecystectomy that requires conversion to open procedure can be predicted by preoperative ultrasonography.JSLS 2002;6:59-63.
Joshi MR, Bohara TP, Rupakheti S, Parajuli A, Shrestha DK, Karki D, Laudari U. Preoperative prediction of difficult laparoscopic Cholecystectomy. JNMA,.2015 Oct-Dec;53(200):221-226. DOI: https://doi.org/10.31729/jnma.2734
Downloads
Published
How to Cite
Issue
Section
License
With the licence CC-BY, authors retain the copyright, allowing anyone to download, reuse, re-print, modify, distribute, and/or copy their contribution. The work must be properly attributed to its author.
It is not necessary to ask for further permission from the author or journal board.
This journal provides immediate open access to its content on the principle that making research freely available to the public supports a greater global exchange of knowledge.
