{"title":"PREDICTING THE RISK FACTOR FOR DIFFICULT LAPAROSCOPIC CHOLECYSTECTOMY: AN OBSERVATIONAL STUDY","authors":"Manojit Barman, Diptangshu Das, Arunava Jana, Pathik Shit","doi":"10.36106/ijsr/9205053","DOIUrl":null,"url":null,"abstract":"Background: Laparoscopic Cholecystectomy (LC) has become the gold standard in the treatment of symptomatic gallstones and it is the most\nfrequent operation now-a-days for gallbladder stones. At times laparoscopy becomes difcult and may need conversion to open cholecystectomy.\nThe prediction of a difcult cholecystectomy has traditionally been based on certain pre-operative clinical and imaging factors. Aim: To study the\nfactors determining the preoperative predictability of difcult LC based on the patient's history, physical examination and abdominal\nultrasonography. Methods: 359 patients diagnosed cholelithiasis, admitted to general surgery department, KPC MCH, Kolkata-32, West Bengal.\nAll of them underwent elective LC, and were operated by experienced laparoscopic surgeons between July 2022 and November 2023. Study\ndesign: Observational study. Results: In our study out of 359 cases 221 are male and 138 are female, male are more predominant than females\n(61% vs 38%). Among 359 patients 76 (21%) patients were found for difcult cholecystectomy. On multivariate logistic regression revealed that\nmale gender, older age, H/O acute attacks, positive Murphy´s sign, past H/O acute cholecystitis requiring hospitalisation, recent H/O jaundice, past\nH/O co-morbidities, H/O ERCP for choledocholithiasis, H/O gall stone pancreatitis, increased gall bladder wall thickness, peri-cholecystic\noedema/ collection, brotic gall bladder, intra-operative ndings of dense adhesion at calot´s triangle were independent predictors of difcult LC.\nConclusion: Pre operative prediction of possible difculties may help a surgeon in choosing the appropriate approach suitable for a particular\npatient. Patients can pre-op be informed about possible risk of conversion to open cholecystectomy","PeriodicalId":14358,"journal":{"name":"International journal of scientific research","volume":"24 6","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International journal of scientific research","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.36106/ijsr/9205053","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Laparoscopic Cholecystectomy (LC) has become the gold standard in the treatment of symptomatic gallstones and it is the most
frequent operation now-a-days for gallbladder stones. At times laparoscopy becomes difcult and may need conversion to open cholecystectomy.
The prediction of a difcult cholecystectomy has traditionally been based on certain pre-operative clinical and imaging factors. Aim: To study the
factors determining the preoperative predictability of difcult LC based on the patient's history, physical examination and abdominal
ultrasonography. Methods: 359 patients diagnosed cholelithiasis, admitted to general surgery department, KPC MCH, Kolkata-32, West Bengal.
All of them underwent elective LC, and were operated by experienced laparoscopic surgeons between July 2022 and November 2023. Study
design: Observational study. Results: In our study out of 359 cases 221 are male and 138 are female, male are more predominant than females
(61% vs 38%). Among 359 patients 76 (21%) patients were found for difcult cholecystectomy. On multivariate logistic regression revealed that
male gender, older age, H/O acute attacks, positive Murphy´s sign, past H/O acute cholecystitis requiring hospitalisation, recent H/O jaundice, past
H/O co-morbidities, H/O ERCP for choledocholithiasis, H/O gall stone pancreatitis, increased gall bladder wall thickness, peri-cholecystic
oedema/ collection, brotic gall bladder, intra-operative ndings of dense adhesion at calot´s triangle were independent predictors of difcult LC.
Conclusion: Pre operative prediction of possible difculties may help a surgeon in choosing the appropriate approach suitable for a particular
patient. Patients can pre-op be informed about possible risk of conversion to open cholecystectomy