PREOPERATIVE PREDICTION OF DIFFICULT LAPAROSCOPIC CHOLECYSTECTOMY: IN ZAGAZIG UNIVERSITY HOSPITALS
Abstract
Background: Laparoscopic Cholecystectomy (LC) becomes the standard of care for
patients requiring removal of gallbladder. LC may be rendered difficult by various
problems encountered during procedure. Several factors have been implicated with a
difficult case, but no reliable criteria are available yet to identify patients
preoperatively with a difficult LC. Preoperative prediction of a difficult LC can help
the patient as well as the surgeon prepare better for the intraoperative challenges and
tailored approach accordingly. The present study was undertaken to
determine the association between preoperative clinical, laboratory and abdominal
sonographic findings in patients undergoing LC for cholelithiasis and the technical
difficulty at operation and to predict the most important indicators that affect the
operation outcome in order to make the procedure safer for the patient as well as the
surgeon.
Methods: In 300 consecutive patients who underwent LC during 2014 to 2016
patient‟s characteristics, clinical history, laboratory data, ultrasonography results and
intraoperative details were prospectively analyzed to evaluate predictors of difficult
LC.
Results: Gender, age, obesity, history of hospitalization for acute cholecystitis,
history of previous ERCP, history of previous abdominal surgery, Gall bladder size,
GB wall thickening, pericholecystic fluid collection, large multiple GB stones and
liver US findings; The above mentioned factors were found to have a statistical
significant association with the final operation out come.
Conclusions: Obesity, presence of history of previous abdominal surgery, gall
bladder wall thickness and gallbladder stone size by preoperative ultrasound; were
found to be the predictive factors of difficult LC in our study.
Keywords: Preoperative, Difficult, Laparoscopic cholecystectomy, Prediction.
patients requiring removal of gallbladder. LC may be rendered difficult by various
problems encountered during procedure. Several factors have been implicated with a
difficult case, but no reliable criteria are available yet to identify patients
preoperatively with a difficult LC. Preoperative prediction of a difficult LC can help
the patient as well as the surgeon prepare better for the intraoperative challenges and
tailored approach accordingly. The present study was undertaken to
determine the association between preoperative clinical, laboratory and abdominal
sonographic findings in patients undergoing LC for cholelithiasis and the technical
difficulty at operation and to predict the most important indicators that affect the
operation outcome in order to make the procedure safer for the patient as well as the
surgeon.
Methods: In 300 consecutive patients who underwent LC during 2014 to 2016
patient‟s characteristics, clinical history, laboratory data, ultrasonography results and
intraoperative details were prospectively analyzed to evaluate predictors of difficult
LC.
Results: Gender, age, obesity, history of hospitalization for acute cholecystitis,
history of previous ERCP, history of previous abdominal surgery, Gall bladder size,
GB wall thickening, pericholecystic fluid collection, large multiple GB stones and
liver US findings; The above mentioned factors were found to have a statistical
significant association with the final operation out come.
Conclusions: Obesity, presence of history of previous abdominal surgery, gall
bladder wall thickness and gallbladder stone size by preoperative ultrasound; were
found to be the predictive factors of difficult LC in our study.
Keywords: Preoperative, Difficult, Laparoscopic cholecystectomy, Prediction.
Full Text:
PDFRefbacks
- There are currently no refbacks.