A clinical evaluation of the predictor variables for difficult laparoscopic cholecystectomy: a prospective study.
European Journal of Molecular & Clinical Medicine,
2020, Volume 7, Issue 10, Pages 3680-3689
AbstractAim: to determine predictive factors for difficult laparoscopic cholecystectomy.
Material and Methods: This was a prospective study conducted in the Department of Department of General Surgery, Indira Gandhi Institute of Medical Science, Patna, Bihar. For 2.5 year. 200 patients who were diagnosed with cholelithiasis and had laparoscopic cholecystectomy were included in this study. We analysed the type and frequency of intraoperative and postoperative complications, as well as factors that increase the risk for development of complications. We noted causes and incidence of conversions and the way they resolved. We noted gender, age, body mass index (BMI), white blood cell count, and level of C-reactive protein (CRP), preoperative ultrasonographic findings, pathophysiological findings of the surgically removed gallbladder, as well as their correlation with the occurrence of complications.
Results: Out of the 200 patients in the study, 139 were female (69.5%), and 61 were male (30.5%). The median age was 50.5 years, including participants that were 18 to 86 year old. There were 27 patients (13.5%) with intraoperative complications (IOC). The most common complications noted were: iatrogenic perforations of the gallbladder- 9 (4.5%), bleeding from the tissues adjacent to the gallbladder 5 (2.5%), gallstones spilt into the peritoneal cavity 3 (1.5%). Intraoperative bleeding from the cystic artery occurred in 1 (0.5%), bleeding from the port in 1 (0.5%) and bleeding from the ligaments of the liver in 1 patients (1%). Conclusion: It is important recognising IOC complications during the surgery so they are taken care of in a timely manner during the surgical intervention.
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