Evaluation of Preoperative Risk Factors for Converting Laparoscopic to Open Cholecystectomy

Lee, Nathan W; Collins, Jay; Britt, Rebecca C.; Britt, L. D.

doi:10.1177/000313481207800815

Cited by 52 publications

(44 citation statements)

References 6 publications

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“…3 In a study conducted by Rabindra Nidoni et al in 180 cases found that majority of the patients were in the age group of 31-50years of age. 4 Age>50 years had been found to be a significant risk factor for difficult cholecystectomy by Lee NW et al 5 Kama et al, reviewed 1000 patients of cholelithiasis and found that 41.7% were >60years of age and had conversion rate of 7% as compared to 3.9% in patients <60years of age. 6 The majority of our patients were in the age group of 31-50years of age which corroborate with the study of Prasant S. Dhanke et al and Rabindra Nidoni et al 2,4 In our study it was observed that difficult cholecystectomy was noted in patients 50years of age, which is similar to the study of Lee NW et al and Kama et al 5,6 In a study conducted by Rabindra Nidoni et al in 180 cases found that Male: Female was 1:1.76.…”

Section: Resultsmentioning

confidence: 99%

Prediction of difficult cholecystectomy, a study of 100 cases

Tudu

Mishra

2018

Int J Res Med Sci

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Background: Cholelithiasis is a common problem in day to day surgical practice, which has a prevalence of 10-15%. The prevalence is more here in this part of the country as this is a pocket of sickle cell disease region. Laparoscopic cholecystectomy is the gold standard procedure for gall stone diseases. Out of many complications one of the most important complications of laparoscopic cholecystectomy is bile duct injury particularly in difficult cases. Difficulties arise during creation of pneumoperitonium, releasing adhesion, identifying anatomy, anatomical variations and during extraction of gall bladder.Methods: A prospective study was carried out at VSS institute of Medical Science and Research, Burla, Sambalpur, a tertiary referral centre and a teaching hospital in the western Odisha. One hundred patients with symptomatic cholelithiasis were taken up for the study after due clearance from the institutional ethical committee. They were evaluated for risk factors such as-age of the patient, sex of the patient, previous abdominal surgery, number of previous attacks, total WBC count, gall bladder wall thickness and pericholecystic collection on ultrasonography.Results: Previous abdominal surgery, duration since acute attack, number of previous attacks, ultrasonography findings of increased wall thickness, stone impaction at neck and pericholecystic collection, increased total WBC count are associated with difficult laparoscopic cholecystectomy.Conclusions: The predictors for difficult cholecystectomy will make the surgeon extra cautious during the procedure so as to minimize the complications.

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Section: Resultsmentioning

confidence: 99%

Prediction of difficult cholecystectomy, a study of 100 cases

Tudu

Mishra

2018

Int J Res Med Sci

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“…12 In many studies, it has been stated that abdominal and epigastrium surgery might be a risk factor for conversion to open surgery. 13,14 However, there also are publications stating that it is not a risk factor. 15,16 In our study, we determined that prior abdominal surgery was not a risk factor but an adhesion makes dissection in Calot's triangle more difficult and this is a risk factor for conversion to open surgery (p < 0.05).…”

Section: Discussionmentioning

confidence: 99%

Preoperative and postoperative risk factors in laparoscopic cholecystectomy converted to open surgery

Ekici¹,

Tatlı²,

Kanlıöz³

2019

Adv Clin Exp Med

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Ekici U, Tatlı F, Kanlıöz M. Preoperative and postoperative risk factors in laparoscopic cholecystectomy converted to open surgery. AbstractBackground. Laparoscopic cholecystectomy (LC) is nowadays the gold standard in the surgical treatment of cholelithiasis and gallbladder diseases. But sometimes it may be inevitable to convert it to open surgery to safely end the procedure.Objectives. In this study, we aimed to investigate the risk factors for conversion to open surgery from LC.Material and methods. The records of patients that underwent LC in Malatya State Hospital (Malatya, Turkey) between January 2013 and May 2014 were prospectively examined. One hundred and forty-five patients were involved in this study. The patients were divided into 2 groups: LC patients and patients converted to open surgery. For the patients in both groups, the preoperative age, gender, body mass index (BMI), disease history, previous abdominal operations, and preoperative laboratory findings were recorded, as well as the fact if the abdominal ultrasonography (US) and endoscopic retrograde cholangiopancreatography (ERCP) were performed. Results.Of 145 patients involved in this study, 127 (87.5%) were female and 18 (12.5%) were male; their mean age was 46.54 years. Nineteen of the patients were operated on after ERCP due to acute cholecystitis and 6 patients were operated on after ERCP due to choledocholithiasis. In 134 of the patients (92.4%), the operations were completed laparoscopically, while the process was converted to open surgery in 11 cases (7.6%). Male gender, chronic disease history, normal BMI level, increased thickness of the gallbladder wall, increased preoperative blood glucose level, leukocytosis, preoperative ERCP history, grade 3 or 4 (Blauer scoring system) adhesions determined during the operation, and multiple stone presence in the bladder were found to be statistically significant risk factors for conversion to open surgery. Conclusions.Patients in the risk group should be informed by experienced laparoscopic surgeons about the potential conversion to open surgery and decision on such conversion should be made when necessary.

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“…Factors associated with a need for conversion are the degree of inflammation, previous upper abdominal surgery, acute cholecystitis, advanced age, male gender, dense adhesions, and obscure anatomy in Calot's triangle. 19,20 Laparoscopic ultrasound can diminish the rate of conversions without additional risk for the patient by providing exact navigation in the operating field: the decision of whether or not to convert to open surgery is based on visual monitoring of the vessels and the CBD, not on leaking bile and a hole in the portal vein or the hepatic artery. The question of protective bile duct stenting before surgery remains open; in our study it helped to delineate anatomy, and there were no conversions in the group of patients given stents prior to the LC.…”

Section: Discussionmentioning

confidence: 99%

Using laparoscopic ultrasound to delineate dangerous anatomy during difficult laparoscopic cholecystectomies

Sebastian¹,

Sroczyński²,

Rudnicki³

2019

Adv Clin Exp Med

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Background. Bile duct injury (BDI) during laparoscopic cholecystectomy (LC) is not as common now as in the past, but it is still a very debilitating complication. Therefore, there is a very strong need for a method that lowers the number of complications during LC without any additional risks for the patient and the operating team. Laparoscopic ultrasound (LUS), which serves to delineate anatomy, appears to be a very effective and safe technique. Objectives. The aim of this study was to explore the advantages of performing LUS during difficult LC. Material and methods. The study group consisted of 126 patients who underwent surgery between January 2014 and February 2016. All the patients had difficult intraoperative anatomical conditions due to chronic inflammation, previous upper abdominal surgery or biliary pancreatitis in the past. We used a Toshiba PEF-704 LA laparoscopic probe and the Toshiba NemioMX SSA-590A diagnostic ultrasound system (Toshiba Corp., Tokyo, Japan). Doppler sonography was used to differentiate between vascular and biliary structures. Results. Laparoscopic ultrasound ensured a safe plane of dissection and no biliary or vascular complications were observed. Stent insertion into the common bile duct before the operation undoubtedly made the identification of anatomical structures easier. Conversion to an open procedure was deemed necessary in only 6 patients (4.8%). Conclusions. Laparoscopic ultrasound facilitates the successful performance of LCs. It can be used at any time during the operation; it is noninvasive; and there is no need to use X-rays or contrast dye, or to cannulate the cystic duct. The most important advantage of LUS is that it leads to a lower number of conversions and intraoperative complications by identifying anatomical relationships in the plane of dissection.

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Evaluation of Preoperative Risk Factors for Converting Laparoscopic to Open Cholecystectomy

Cited by 52 publications

References 6 publications

Prediction of difficult cholecystectomy, a study of 100 cases

Prediction of difficult cholecystectomy, a study of 100 cases

Preoperative and postoperative risk factors in laparoscopic cholecystectomy converted to open surgery

Using laparoscopic ultrasound to delineate dangerous anatomy during difficult laparoscopic cholecystectomies

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