Details
Category: Volume 07 Issue 01 January 2019
Hits: 1312

Title: A Study of Preoperative factors predicting difficult Laparoscopic Cholecystectomy

Authors: Dr Md. Masleh Uddin, Dr Sanju Sharma, Dr Radhika Raman

 DOI: https://dx.doi.org/10.18535/jmscr/v7i1.153

Abstract

Introduction

Cholecystectomy is the most common elective procedure performed on hepato-biliary system. Laparoscopic cholecystectomy has become the gold standard for benign gallbladder disease in very short time1. Sometimes Laparoscopic cholecystectomy becomes difficult when there is congenital arterial, ductal or structural anamoly of gallbladder is present2. Acute inflammation with gangrenous gallbladder, dense adhesions, small, fibrotic, thick walled gall bladder, cholecysto-enterocholic fistula will cause difficulty in performing Laparoscopic cholecystectomy. Other risk factors3 like old age, male sex, obesity, clinical signs of acute cholecystitis, prior upper abdominal surgery, impacted stones, and pericholecystic fluid will further add to difficult Laparoscopic cholecystectomy.4

Preoperative prediction of conversion or difficulty atsurgery is an important aspect of planning Laparoscopic cholecystectomy. An accurate prediction may become necessaryfor counselling the patient and their attendants regarding conversion to open cholecystectomy. The surgeon may get indication so that he may accordingly schedule the time and team for surgery. Patients may be informed for longer hospitalisation and more intense post operative care. Hospital administration may manage their admission and bed vacancy efficiently.

Objectives

The objective of the study was to predict difficult Laparoscopic cholecystectomy and to establish relationship between the preoperative clinical and diagnostic evaluation. 

References

  1. Adnan Mehraj, Muhammad Ali Naqvi. Shizan Hamid Feroz, Haroon ur Rasheed. Laparoscopic cholecystectomy : An audit of 500 patients. J Ayub Med Coll, Abbottabad 2011;23:88-89
  2. Singh K, Ohri A. Difficult laparoscopic cholecystectomy : A large series from north India. Ind. J Surg. 2006;68(4):205e8
  3. Abdel Baki NA, Motawei MA, Soliman KE, et.al. Pre-operative prediction of difficult Laparoscopic cholecystectomy using clinical and ultrasonographic parameters. JMRI 2006;27(3):102e7.
  4. Kama NA, Kologlu M, Doganayet.al. A risk score for conversion from laparoscopic to open cholecystectomy Am J Surg 2001;181:520e5.
  5. Randhawa JS, Pujahari AK. Preoperative prediction of difficult Lapchole: A scoring method. Indian J Surg 2009;71:198-201.
  6. Gupta N, Ranjan G, Arora MP, Goswami B, Chaudhary P. Validation of a scoring system to predict difficult laparoscopic cholecystectomy. Int J Surg 2013;11:1002-06.
  7. Gupta V et al. Preoperative Prediction of difficult Laparoscopic Cholecystectomy- A scoring system. IJSR.2017 march; 6;13:1041-43.
  8. Agarwal N, Singh S, Khichy S. Preoperative prediction of Difficult Laparoscopic Cholecystectomy: A Scoring Method. Nigerian J of Surg. 2015; 21(2): 130-33.
  9. Genc V, Sulaimanov M, Cipe G, Basceken S I, Gurel NEM, Aras N, Hazinedaroglu SM. What necessitates the conversion to open Cholecystectomy? A retrospective analysis of 5164 consecutive laparoscopic operations: Clinics. 2011; 66(3):417-20.
  10. Vander Steeg HJJ et al. Risk factors for conversion during laparoscopic Cholecystectomy-experiences from a Scandinavian Journal of surgery 2011. 100:169-73.
  11. Bouarfa L, Schneider A, Feussner H, Navab N, Lemek HU, Jonker PP, et al. Prediction of intraoperative complexity from preoperative patient data for laparoscopic Cholecystectomy. ArtifIntell Med 2011 Jul;52(3): 169-76.
  12. Hussain A. Difficult laparoscopic cholecystectomy: current evidence and strategies of management. Surglaparosc Endosc Percutan Tech 2011;21(4);211-17.
  13. Karayiann AJ, Polychronidi A, Perent S. Laparoscopic Cholecystectomy in patients with previous upper or lower GI surgery. Surgical Endoscopy 2004; 18:1097-1101.
  14. Rosen M, Brody F, Posky J. Predictive factors for conversion of Laparoscopic Cholecystectomy. Am J Surg 2002;184(3):254-8.
  15. Nachnani J, Supe A. Pre-operative prediction of difficult Laparoscopic Cholecystectomy using clinical and ultrasonographic parameters. Indian J Gastroentrol 2005;24(1):16-18.

Corresponding Author

Dr Radhika Raman

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.