PRE-OPERATIVE ASSESSMENT TO PREDICT DIFFICULT LAPAROSCOPIC CHOLECYSTECTOMY
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 5, Pages 71-93
Abstract
Background: This research aimed to determine, prior to surgery, what factors, if any, could help a surgeon anticipate a "difficult cholecystectomy" using either laparoscopic or open surgery. Consecutive patients undergoing cholecystectomies (both open and laparoscopic) for gallstone-related disorders are analysed to see which factors best predict the presence or absence of surgical complications. The goal of this study is to determine which clinical, laboratory, and radiographic criteria are most indicative of difficult dissection during cholecystectomy. To develop a scoring system prior to surgery that can accurately predict the result during the procedure.Results: A cholecystectomy is a common surgical procedure. Those who experience symptoms from gallstone disease are increasingly likely to opt for laparoscopic cholecystectomy. The incidence of both complications and conversions are higher in patients who are already at high risk, as well as in complex cases that provide technical challenges. The current study included 123 individuals with confirmed cases of cholelithiasis who were scheduled to have surgery. The results and discoveries were recorded and scored intraoperatively. The range of possible grades was 0–15. In this case, a score of 5 or below indicated an easy task, 6–10 indicated a moderately difficult task, and 11–15 indicated a very challenging task. Two categories, "Easy" (scores of 5) and "Difficult" (scores of >6), were made for the purpose of statistical analysis. Demographic, clinical, laboratory, and imaging parameters were collected before to surgery and compared to the two intra-operative groups to identify any possible correlations.
Conclusion: 123 patients with cholelithiasis were the subjects of a prospective study. Data from these patients' demographics, imaging, and metabolic profiles, as well as their intra-operative outcomes, were compared. All 123 patients used in the study underwent laparoscopic procedures. Of the 123 cholecystectomies performed laparoscopically, 113 were successful without having to resort to open surgery. In this analysis, we find a conversion rate of 8%. It is 33.3% greater in cases of acute cholecystitis.
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