Preoperative Prediction of the Difficulty of Laparoscopic Cholecystectomy

Saber, Aly

doi:10.17352/2455-2968.000004

Cited by 6 publications

(9 citation statements)

References 25 publications

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“…When it was soaked by 50% this means that it contains about 25 ml of blood and if soaked; 100% this means that it contains 75 ml of blood. 20 Many researchers reported a significant reduction of intraoperative blood loss by the use of suture less techniques in total thyroidectomy when compared with the conventional suture ligation technique and study data came in agreement with those reported results. [21][22][23] Al Juraibi et al also reported that the amount of intraoperative blood loss was 50-75 ml in sutureless group (mean 62.06±7.34) and 60-90 in the conventional group (mean 75.84±9.21).…”

Section: Discussionsupporting

confidence: 76%

A comparative study between harmonic scalpel hemostasis and conventional hemostasis in total thyroidectomy

Sherpiny

2020

Int Surg J

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Background: Thyroidectomy is the most commonly performed procedure in endocrine surgery. Since the thyroid gland is highly vascular, therefore, rapid and absolute hemostasis is extremely required. Conventional thyroidectomy is commonly used with acceptable outcomes, however, it is time‑consuming and resulted in significant intraoperative blood loss with the possible risk of postoperative hemorrhage, injury to parathyroid glands and laryngeal nerves. The advent of focus harmonic devices was encouraging for improving safety, effectiveness, and reduction of operative time, especially in thyroid surgery. Aim of this study: The purpose of this study was to analyze the effectiveness and surgical outcomes of using ultrasonic harmonic scalpel for thyroid surgery compared to conventional techniques.Methods: This was a prospective, randomized study in which 60 patients with various types of goiters presented for thyroidectomy. The patients were divided into two comparable groups. Group A (30 patients) included patients who had focus harmonic thyroidectomy and Group B (30 patients) included patients who underwent conventional thyroidectomy.Results: Focus harmonic thyroidectomy showed a significant reduction in operative time, intraoperative blood loss, volume of postoperative fluid drainage and meantime for hospital stay compared with conventional thyroidectomy. There were no significant differences in the incidence of postoperative hypocalcemia, seroma, hematoma, wound infection and laryngeal nerve injury between both groups.Conclusions: Focus harmonic thyroidectomy was a safe, effective, faster, and appealing alternative to conventional technique since it reduced the operative time, intraoperative blood loss, postoperative drainage and hospital stay with comparable postoperative complications.

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Section: Discussionsupporting

confidence: 76%

A comparative study between harmonic scalpel hemostasis and conventional hemostasis in total thyroidectomy

Sherpiny

2020

Int Surg J

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“…In a study of 204 patients with difficult situation cholecystitis in 2015, so the conversion rate was slightly high (7.35%). 8 Almost all LC are done in elective basis in our hospital. This might be the reason for slightly lower rate of conversion to open cholecystectomy in our study.…”

Section: Discussionmentioning

confidence: 99%

“…It was 3mm [12][13][14] or 4mm. 8 Critical gall bladder wall thickness was taken as 4mm in our study. Thickened gall bladder wall was found in 15 patients and was a significant predictor for difficulty.…”

Section: Discussionmentioning

confidence: 99%

Assessment of a Scoring System to Predict Difficult Laparoscopic Cholecystectomy

Sigdel

Subedi

Phuyal

et al. 2020

Journal of Institute of Medicine

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Introduction Laparoscopic cholecystectomy (LC) has become the procedure of choice for management of symptomatic gallstone disease. It would be useful to have some reliable predictive factors for conversion in LC. Our aim is to predict difficult laparoscopic cholecystectomy preoperatively by using a scoring system. MethodsA total of 136 patients were included. The parameters considered for this study were old age, male sex, history of hospitalization, obesity, abdominal surgery scar, palpable gall bladder, gall bladder wall thickness, pericholecystic collection and impacted stone. ResultsAmong 136 cases, 70.6% were easy, 24.3% were difficult and 5.1% were very difficult intraoperatively. The factors like age >50 years, history of hospitalization for acute cholecystitis, previous abdominal surgery, palpable gall bladder, wall thickness >4mm and impacted stone were found statistically significant in predicting difficult LC. The preoperative scoring is statistically and clinically a good test for predicting the difficult LC (area under the curve = 0.824) with sensitivity of the test being 82.3% and specificity 72.7%. Conversion rate was 3.67%. ConclusionThe factors like age >50 years, history of hospitalization for acute cholecystitis, previous abdominal surgery, palpable gall bladder, wall thickness >4 mm and impacted stone are the preoperative predictors of difficult LC.

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“…Surgeon-specific parameters were not included, observed or considered in this study. Some of these parameters were recognized in the literature as indicators of difficulty [15, [18][19][20][21]. Saber and coworkers estimated the difficulty of LC in a group of patients only with acute cholecystitis, but did not propose a prediction model [21].…”

Section: Discussionmentioning

confidence: 99%

“…Some of these parameters were recognized in the literature as indicators of difficulty [15, [18][19][20][21]. Saber and coworkers estimated the difficulty of LC in a group of patients only with acute cholecystitis, but did not propose a prediction model [21]. Surge and coworkers offered a scoring system based on operative findings and the degree of cholecystitis in order to outline key operative findings [22].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of difficulties in laparoscopic cholecystectomy

2017

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Introduction. For decades, laparoscopic cholecystectomy has been the gold standard in surgical treatment of patients with cholelithiasis all over the world. The main advantage of this approach is that it is a minimally invasive procedure for patients. Although this method is a routine in our country, there are certain cases where the presumed outcome of minimally invasive procedure is not achieved, and the surgery is converted to open surgery, or a subsequent laparoscopic surgery is performed, in order to deal with the complications. The aim of this study was to establish if it was possible to create a model for preoperative prediction of difficult laparoscopic cholecystectomies. Material and Methods. Two groups of patients were analyzed. Group A included patients with cholelithiasis who were studied in order to determine parameters associated with difficult laparoscopic cholecystectomies. Out of 16 analyzed parameters, 8 showed significant correlation with difficult laparoscopic cholecystectomies. Based on these parameters, a prediction model was established, consisting of five groups: I - easy (score 1), II - laparoscopic cholecystectomy with mild difficulties (score 2), III - laparoscopic cholecystectomy with major difficulties (score 3), IV - difficult (score 4), V - conversion to open surgery is expected (score 5). This model was preoperatively applied in patients with cholelithiasis included in group B. Results. The overall predictability of the model was 82%. The greatest prediction accuracy was achieved in groups II and III (98.3% and 100%, respectively). Conversion to open cholecystectomy was predicted in 76% of patients. Conclusion. Based on certain preoperative parameters it is possible to establish a model to predict a difficult laparoscopic cholecystectomy.

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Preoperative Prediction of the Difficulty of Laparoscopic Cholecystectomy

Cited by 6 publications

References 25 publications

A comparative study between harmonic scalpel hemostasis and conventional hemostasis in total thyroidectomy

A comparative study between harmonic scalpel hemostasis and conventional hemostasis in total thyroidectomy

Assessment of a Scoring System to Predict Difficult Laparoscopic Cholecystectomy

Evaluation of difficulties in laparoscopic cholecystectomy

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