Title: A Clinical Study to Determine Predictive Factors for Difficult Laparoscopic Cholecystectomy

Authors: Dr H.B. Janugade, Dr Parth Yadav

 DOI: https://dx.doi.org/10.18535/jmscr/v7i3.133

Abstract

Background: Laparoscopic cholecystectomy is one of the most common surgeries performed and has replaced open cholecystectomy. Laparoscopic cholecystectomy is associated with better preservation of immune function and a reduction of the inflammatory response compared with open surgery.

Objective: To evaluate the predictive factors responsible for difficult laparoscopic cholecystectomy.

Material and Methods: The present prospective study was conducted in Department of Surgery from September 2016 to October 2018. A total sample size of 67 patients admitted in the department of various surgical wards in tertiary health center with diagnosis of cholelithiasis/ cholecystitis who were clinically evaluated and confirmed by USG included in the study population. Patients below 18 years of age, with CBD calculus, raised ALP, dilated, CBD, where CBD exploration was needed, obstructive jaundice ant not willing for laparoscopic cholecystectomy were excluded. The study was conducted after taking ethical clearance from the institute and informed consent from the patients. The data was collected and analysis done by SPSS version 22.

Results: The maximum numbers of cases were in the age group of 51-60 years (28.36%), with female dominance (68.66%) Chronic recurring pain was the main symptom seen in all 67 patients. The rate of conversion from laproscopic cholecystectomy to open cholecystectomy was 8.96%. BMI, H/O acute cholecystitis, thick wall, impacted stone and Pericholecystic collection showed statistical significant association with pre operative score.

Conclusion: The preoperative scoring is statistically and clinically a good test for predicting the operative outcome in laparoscopic cholecystectomy.

Keywords: Laproscopic cholecystectomy, predictive factors, preoperative scoring. 

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Corresponding Author

Dr Parth Yadav

PG Student