Role of preoperative sonography in predicting conversion from laparoscopic cholecystectomy to open surgery

Tosun, Alptekin; Hancerliogullari, Kadir Oymen; Şerifoğlu, İsmail; Çapan, Yavuz; Ozkaya, Enis

doi:10.1016/j.ejrad.2014.12.006

Cited by 17 publications

(21 citation statements)

References 21 publications

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“…So, some factors may suggest the possibility of conversion to laparotomy and it can be evidenced by ultrasonography. The indicative of difficulties are: thick gallbladder wall, distension of the gallbladder, size of gallstones, diameter of the common bile duct, impacted stones in biliary tract, perivesicular liquid and diameter of VB 6 , 12 , 15 , 18 , 20 , 24 , 27 . Although there is no consensus in the literature about the importance of all parameters together mentioned above, different studies agree on the role of preoperative ultrasonography to predict difficulty and/or surgical conversion.…”

Section: Discussionmentioning

confidence: 99%

“…Although there is no consensus in the literature about the importance of all parameters together mentioned above, different studies agree on the role of preoperative ultrasonography to predict difficulty and/or surgical conversion. Some authors consider even that radiologists should indicate the risk to conversion in the USG report 4 , 27 .…”

Section: Discussionmentioning

confidence: 99%

“…They are: male gender, age over 70 years, biliary colic for the last three weeks before surgery, acute cholecystitis history treated conservatively, previous surgery of the upper abdomen, pain and stiffness in the upper right quadrant. These scores have been proposed for clinical and sonographic concurrently, and can help in surgical planning 7 , 13 , 18 , 23 , 27 , 29 .…”

Section: Discussionmentioning

confidence: 99%

“…Preoperative ultrasonography is valuable in determining surgical difficulties or even chance to laparotomic conversion 6 , 12 , 15 , 18 , 20 , 24 , 27 . The wall thickness and the diameter of the common bile duct may indicate greater difficulties in some steps of the operation 6 .…”

Section: Introductionmentioning

confidence: 99%

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Comparative Analysis of Preoperative Ultrasonography Reports With Intraoperative Surgical Findings in Cholelithiasis

Kreimer

Cunha

Ferreira

et al. 2016

ABCD, arq. bras. cir. dig.

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Background: Laparoscopic cholecystectomy is widely used for cholelithiasis. Abdominal ultrasonography often precedes this operation and can prove diagnosis, as well as helps in showing possible complications during the perioperative period. Aim: Evaluate the description of variables of gallbladder and bile ducts present in reports of preoperative abdominal ultrasonography in cholelithiasis comparing with surgical findings. Methods: Were studied 91 patients who underwent elective laparoscopic cholecystectomy with previous abdominal ultrasonography. Variables such as identification and amount of gallstones involved were evaluated, both in preoperative ultrasonography and during surgery to evaluate sensitivity, specificity, concordance and positive and negative predictive values. Results: The reports did not mention diameter of vesicular light (98.9%), organ distension (62.6%), gallstone sizes (58.2%), wall thickness (41.8%) and evaluation of the common bile duct (39.6%). Ultrasound had high values for sensitivity, consistency and positive predictive value for identifying the presence/absence of gallstones: 98.8%, 96.7% and 97.8% respectively. As for the amount of stones, ultrasonography showed agreement in 82.7%, negative predictive value in 89.1% and specificity in 87.7%, with lower values for sensitivity (68.2%) and positive predictive value (65.2%). Conclusions: The ultrasound reports were flawed in standardization. Significant percentage of them did not have variables that could predict perioperative complications and surgical conversion.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Comparative Analysis of Preoperative Ultrasonography Reports With Intraoperative Surgical Findings in Cholelithiasis

Kreimer

Cunha

Ferreira

et al. 2016

ABCD, arq. bras. cir. dig.

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“…Gupta G et al (2015), [15] Tosun A et al (2015) & Gaurav Gupta et al (2015) evaluated role of various factors responsible for conversion from laparoscopic to open cholecystectomy and also studied the intraoperative problems faced by the surgeon responsible for conversion in order to make the procedure safer for the patient as well as the surgeon. [16,17] Significant predictors of conversion were obscured anatomy of Calot's due to adhesions, sessile gall bladder, male gender and gall bladder wall thickness >3 mm. In our study 25.4% of the patients were managed by OC.…”

Section: Discussionmentioning

confidence: 99%

Role of Ultrasonography (USG) in Evaluation of Pericholecystic Adhesions in Gallstone Disease (GSD)

Wani¹,

Rastogi²,

Pratap³

et al. 2017

Ann. Int. Med. Den. Res.

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Background: In the recent era of laparoscopic and robotic surgeries, preoperative imaging has become very crucial in selecting the right operative technique in any pathological condition. Though laparoscopic cholecystectomy is widely accepted and practiced surgical technique yet it has limitations especially dense pericholecystic adhesions where the surgeon requires larger field of view for optimal dissection of gall bladder bed and for optimal control of bleeding. Though ultrasonography has been in wide use for preoperative evaluation of gall bladder stone disease yet very few studies have been conducted to evaluate its role in predicting pericholecystic adhesions responsible for difficult laparoscopic cholecystectomy. Prior knowledge of dense pericholecystic adhesions may help the surgeon in opting for open over laparoscopic cholecystectomy. Methods: Out of 70 patients with gall bladder stone disease that were enrolled in the study, complete data could be obtained in only 55 patients. All patients included in the study underwent ultrasonography of abdomen in fasting state and findings were recorded including pericholecystic adhesions & visualisation of Calot's triangle. The ultrasonographic findings were compared with that of the operative findings. Results: Our study revealed that ultrasonography has more than 70% sensitivity, more than 80% specificity and more than 76% accuracy in predicting pericholecystic adhesions which is the major cause of conversion from laparoscopic to open cholecystectomy. Conclusions: Ultrasonography can serve as an inexpensive imaging tool for predicting difficult laparoscopic cholecystectomy in patients with gall bladder stone disease by demonstrating signs of pericholecystic adhesions and nonvisualisation of normal-appearing Calot's triangle.

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Predicting Conversion from Laparoscopic to Open Cholecystectomy: A Single Institution Retrospective Study

et al. 2018

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Advance age, male gender, significant comorbidities and history of prior laparotomies have a high risk of conversion. Patients with these risk factors should be counseled for the possibility of conversion to open surgery preoperatively. Further research is needed to determine whether these high risks patients should be operated on by surgeons with more extensive experience in minimal invasive surgery.

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Role of preoperative sonography in predicting conversion from laparoscopic cholecystectomy to open surgery

Cited by 17 publications

References 21 publications

Comparative Analysis of Preoperative Ultrasonography Reports With Intraoperative Surgical Findings in Cholelithiasis

Comparative Analysis of Preoperative Ultrasonography Reports With Intraoperative Surgical Findings in Cholelithiasis

Role of Ultrasonography (USG) in Evaluation of Pericholecystic Adhesions in Gallstone Disease (GSD)

Predicting Conversion from Laparoscopic to Open Cholecystectomy: A Single Institution Retrospective Study

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