A Retrospective and Prospective Study to Develop a Pre-operative Difficulty Score for Laparoscopic Cholecystectomy

Ibrahim, Yousef; Radwan, Rami; Abdullah, Ali; Sherif, Mohamed; Khalid, Usman; Ansell, James; Rasheed, Ashraf

doi:10.1007/s11605-018-3821-y

Cited by 9 publications

(14 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The present study indicates that symptom duration ≥72 h is the only independent risk factor for DLC (open conversion, operative time ≥120 min, or blood loss ≥500 ml) in patients with AC without any primary treatment. Previous studies have also described risk factors for DLC, such as high CRP level, male sex, older age, high white blood cell count, preoperative ERCP, and gallbladder wall thickness detected by US, 5,[13][14][15][16] but in our study we could not find any statistically significant differences in these items.…”

Section: Discussioncontrasting

confidence: 82%

“…Age, sex, 2. This indicates that CVS was more difficult to create in the DLC group (28 [46%] vs 234 [88%]; P < 0.001), and the hospital stay of the DLC group was significantly longer (6 [4-35] vs 4 [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]; P < 0.001). No significant difference was found in the frequency of complications (P = 1).…”

Section: Resultsmentioning

confidence: 99%

“…As for pathological diagnosis, the frequency of gangrenous cholecystitis was higher in the LLC group but not statistically significant (6 [8%] vs 9 [4%]; P = 0.124). Hospital stay was longer in the LLC group (5 [3-35] vs 4 [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] days; P < 0.001), while the number of complications (Clavien-Dindo grade ≥3) was comparable between the two groups (1 [1%] vs 5 [2%]; P = 1). 12…”

Section: Resultsmentioning

confidence: 99%

“…Regarding the length of hospital stay, the LLC group had a longer hospital stay (5 [3-35] vs 4 [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]: P < 0.001). Several studies have indicated that no significant difference in length of hospital stay was found between the ELC (within 72 h) and LLC groups (beyond 72 h).…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Preoperative risk factors for technical difficulty in emergent laparoscopic cholecystectomy for acute cholecystitis

Ohya

Maeda

Takayama

et al. 2021

Asian J Endoscop Surgery

View full text Add to dashboard Cite

Aim: We have routinely performed emergent laparoscopic cholecystectomy (LC) as soon as we diagnosed acute cholecystitis (AC), if patients could tolerate surgery. This study was conducted to identify the preoperative risk factors that predict the technical difficulty of emergent LC for AC.Methods: A retrospective review of patients with AC who underwent emergent LC between 2012 and 2019 was conducted. Technical difficulty was defined as the presence of the following conditions: open conversion, operative time ≥120 min, or blood loss ≥500 ml.Results: In all, 327 patients were included and divided into difficult LC (DLC, n = 61) and nondifficult LC (non-DLC, n = 266). Multivariate logistic analysis revealed that symptom duration ≥72 h was the only independent risk factor for DLC. Comparison of late LC (beyond 72 h, LLC) and early LC (within 72 h, ELC) showed a lower rate of creation of the critical view of safety and a longer hospital stay, as well as a longer operative time, a larger amount of bleeding, and a higher open conversion rate in LLC. However, the postoperative complication rates were equivalent.Conclusion: LC for AC with symptom duration ≥72 h tends to be technically difficult. However, it is acceptable regarding operative outcomes.

show abstract

Section: Discussioncontrasting

confidence: 82%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Preoperative risk factors for technical difficulty in emergent laparoscopic cholecystectomy for acute cholecystitis

Ohya

Maeda

Takayama

et al. 2021

Asian J Endoscop Surgery

View full text Add to dashboard Cite

show abstract

“…Los criterios de conversión incluyeron intervención urgente/emergente, cirugía abdominal previa, colecistitis necrótica / gangrenosa. (7) Ibrahim et al, en su estudio realizado en 2019, demostraron de manera retrospectiva que el sexo masculino, la edad avanzada, el Índice de Masa Corporal IMC alto y la Colangiopancreatografía Retrógrada Endoscópica (CPRE) previa se asocian significativamente con una mayor duración de la operación, e intentaron establecer de manera prospectiva con estas cuatro variables una puntuación que determinara el aumento en el tiempo quirúrgico y así predecir una colecistectomía difícil; planteando que se puede explicar claramente al paciente su enfermedad, sus posibles complicaciones durante el procedimiento quirúrgico, riesgo de colecistectomía subtotal o de conversión a cirugía abierta, así como también poder establecer que se puede abordar un paciente según esta puntuación prequirúrgica (8) .…”

Section: Introductionunclassified

Colecistectomía Laparoscópica difícil: tratamiento quirúrgico

Núñez

Angelis

Rodríguez

2023

RDP

View full text Add to dashboard Cite

Objetivo: Caracterizar el tratamiento laparoscópico de pacientes con colecistitis difícil en el Servicio de Cirugía I del Hospital Universitario de Caracas durante el quinquenio 2017-2021. Métodos: Estudio retrospectivo, observacional, descriptivo y de corte transversal. Muestra de tipo no probabilístico por conveniencia, seleccionada de la base de datos del Departamento de Historias Médicas del Hospital Universitario de Caracas. El análisis estadístico se realizó con el programa SPSS en su versión 26. Resultados: se recolectaron 61 Historias Clínicas con características de colecistectomías laparoscópicas difíciles, el grupo etario más numeroso con 67,19%, fue entre 30-59 años; sexo predominante: el femenino con 85,2%; el 42,62% de los pacientes presentaron a su ingreso: litiasis vesicular simple, el cólico vesicular persistente fue la complicación más frecuente con 31,23%. El 65,57% se ubicó en Grado I según Nassar como hallazgo intraoperatorio más frecuente, y según Parkland el 75,40% en grado I, sin individuos afectados con Grado V. Todos los casos fueron tratados quirúrgicamente (colecistectomía laparoscópica total). Conclusión: el total de los pacientes sometidos a tratamiento quirúrgico con hallazgos de colecistectomía laparoscópica difícil, se completó mediante colecistectomía laparoscópica total.

show abstract

Usefulness of preoperative drip infusion cholangiography with computed tomography for predicting surgical difficulty during laparoscopic cholecystectomy

Nakazawa

Akamatsu

Miyata

et al. 2020

J Hepato Biliary Pancreat

View full text Add to dashboard Cite

BackgroundDrip infusion cholangiography with computed tomography (DIC‐CT) is a major preoperative modality used for patients undergoing laparoscopic cholecystectomy (LC).MethodsThis study included 218 patients for whom preoperative DIC‐CT images were obtained prior to undergoing LC. The association between gallbladder (GB) opacification in DIC‐CT and the operative time was assessed.ResultsThe GB opacification on the DIC‐CT images was classified as follows: Grade 0, homogeneous opacification; Grade 1, heterogeneous opacification; Grade 2, only cystic duct can be identified; and Grade 3, no opacification. Images obtained for the 218 patients showed 41 (18.8%) with Grade 0, 91 (41.7%) with Grade 1, 54 (24.8%) with Grade 2, and 32 (14.7%) with Grade 3. The operative time and intraoperative blood loss were significantly longer and larger, respectively, in cases classified as Grade 2 or 3 (GB negative) compared with cases classified as Grade 0 or 1 (GB positive). We created an LC difficulty score based on the following variables that were significant independent predictors of increased operative time: GB negativity in DIC‐CT (P = .002, 2 points), GB wall thickness (P = .002, 2 points), body mass index (P = .015, 1 point), preoperative alkaline phosphatase value (P = .018, 1 point), and preoperative C‐reactive protein value (P = .04, 1 point). The LC difficulty score (Grade A, score 0‐2; Grade B, score 3‐5; and Grade C, score 6‐7) was significantly associated with a prolonged operative time.ConclusionDrip infusion cholangiography with computed tomography is useful for predicting the surgical difficulty of LC.

show abstract

A Retrospective and Prospective Study to Develop a Pre-operative Difficulty Score for Laparoscopic Cholecystectomy

Abstract: We have identified four pre-operative variables that predicted a longer duration of surgery. Preliminary results suggest a positive correlation between this scoring system and duration of surgery. An adequately powered prospective multi-centre study is needed to validate our findings.

Cited by 9 publications

References 19 publications

Preoperative risk factors for technical difficulty in emergent laparoscopic cholecystectomy for acute cholecystitis

Preoperative risk factors for technical difficulty in emergent laparoscopic cholecystectomy for acute cholecystitis

Colecistectomía Laparoscópica difícil: tratamiento quirúrgico

Usefulness of preoperative drip infusion cholangiography with computed tomography for predicting surgical difficulty during laparoscopic cholecystectomy

Contact Info

Product

Resources

About