The Modification of a Preoperative Scoring System to Predict Difficult Elective Laparoscopic Cholecystectomy

Tongyoo, Assanee; Liwattanakun, Aekkaphod; Sriussadaporn, Ekkapak; Limpavitayaporn, Palin; Mingmalairak, Chatchai

doi:10.1089/lap.2022.0407

Cited by 11 publications

(9 citation statements)

References 19 publications

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“…Data were collected from medical sheets, operatory protocols, and electronic records of the patients. A predictive score for DLC based on the study by Tongyoo and Randhawa [11] was calculated for each patient, and the predictive value was comparatively analyzed For each patient, a combination of general, clinical and ultrasound parameters were summed. As described by Tongyoo [11], 1 point was added for age over 50 and male sex, while personal history of biliary colic and inflammation added 4 more points.…”

Section: Methodsmentioning

confidence: 99%

“…A predictive score for DLC based on the study by Tongyoo and Randhawa [11] was calculated for each patient, and the predictive value was comparatively analyzed For each patient, a combination of general, clinical and ultrasound parameters were summed. As described by Tongyoo [11], 1 point was added for age over 50 and male sex, while personal history of biliary colic and inflammation added 4 more points. In case of obese or overweight patients, a BMI of 25-27.5 was noted with 1 point, while for more than 27.5, two points were added to individual score.…”

Section: Methodsmentioning

confidence: 99%

“…Several score systems that combined clinical, biological, and imaging parameters were designed to increase the accuracy of preoperative identification of difficult cholecystectomies, including both elective and emergency operated cases [11][12][13][14][15][16][17], combining personal history-related factors with clinical and imaging parameters. Ramirez-Giraldo et al [12] comparatively evaluated the accuracy of seven scoring systems in predicting DLC in the same group of patients that underwent LC and found the best predictive value for the Tongyoo predictive model.…”

Section: Introductionmentioning

confidence: 99%

“…The present study aims to investigate the biological and imaging preoperative factors with predictive value for DLC in patients specifically with acute cholecystitis and to compare their predictive value to the Tongyoo scoring system [11].…”

Section: Introductionmentioning

confidence: 99%

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Predictive Factors for Difficult Laparoscopic Cholecystectomies in Acute Cholecystitis

Stoica,

Serban,

Bratu

et al. 2024

Diagnostics

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Laparoscopic cholecystectomy (LC) is the gold standard treatment in acute cholecystitis. However, one in six cases is expected to be difficult due to intense inflammation and suspected adherence to and involvement of adjacent important structures, which may predispose patients to higher risk of vascular and biliary injuries. In this study, we aimed to identify the preoperative parameters with predictive value for surgical difficulties. A retrospective study of 255 patients with acute cholecystitis admitted in emergency was performed between 2019 and 2023. Patients in the difficult laparoscopic cholecystectomy (DLC) group experienced more complications compared to the normal LC group (33.3% vs. 15.3%, p < 0.001). Age (p = 0.009), male sex (p = 0.03), diabetes (p = 0.02), delayed presentation (p = 0.03), fever (p = 0.004), and a positive Murphy sign (p = 0.007) were more frequently encountered in the DLC group. Total leukocytes, neutrophils, and the neutrophil-to-lymphocyte ratio (NLR) were significantly higher in the DLC group (p < 0.001, p = 0.001, p = 0.001 respectively). The Tongyoo score (AUC ROC of 0.856) and a multivariate model based on serum fibrinogen, thickness of the gallbladder wall, and transverse diameter of the gallbladder (AUC ROC of 0.802) showed a superior predictive power when compared to independent parameters. The predictive factors for DLC should be assessed preoperatively to optimize the therapeutic decision.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Predictive Factors for Difficult Laparoscopic Cholecystectomies in Acute Cholecystitis

Stoica,

Serban,

Bratu

et al. 2024

Diagnostics

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“…Despite the prevalence rate being lower in India at around 6%, the economic and health burdens are similarly impactful, although underreported due to the prevalence of daycare. 8 Since the advent of LC in 1989, cholecystectomy rates have surged, making it the most frequent elective abdominal surgery in the U.S. Despite a trend toward stabilization in the late 1990s, the procedure remains common, underscoring the importance of efficient pre-operative assessment.…”

Section: Burden Of Diseasementioning

confidence: 99%

A prospective study of various pre-operative factors and the development of a scoring system in predicting difficult laparoscopic cholecystectomy

Usha Ramakrishna N,

Radhika Potnuri,

Raj Kumar Sahu

et al. 2024

Asian J Med Sci

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Background: Laparoscopic cholecystectomy (LC) is a common surgical procedure, the difficulty of which can vary significantly based on pre-operative factors. Identifying these factors can improve surgical planning, patient counseling, and outcomes. Aims and Objectives: To develop a predictive scoring system for assessing the difficulty of LC preoperatively based on individual patient parameters. To employ operative time and intra-operative events to validate the accuracy of the scoring system in reflecting the technical difficulty of LCs. Materials and Methods: This prospective study enrolled 104 patients scheduled for LC, assessing them with a pre-operative scoring system to predict operative difficulty. Patients were categorized into groups indicating expected levels of difficulty: Easy, difficult, and very difficult. Demographic information, clinical characteristics, and operative outcomes were analyzed to validate the scoring system’s predictive accuracy. Results: Of the patients assessed, 68.3% were predicted to have an easy LC (scores 0–5), whereas 31.7% were anticipated to face a difficult LC (scores 6–10). Key predictors of operative difficulty included age, sex, history of previous hospitalization for acute cholecystitis, body mass index (BMI), the presence of an abdominal scar, palpable gallbladder (GB), thickened GB wall, pericholecystic collection, and impacted stone. The study found that operative outcomes closely aligned with pre-operative predictions, confirming the scoring system’s moderate predictive accuracy (area under the curve of 0.798). Conclusion: The pre-operative scoring system demonstrated moderate effectiveness in predicting LC difficulty, with significant predictors including a history of hospitalization, BMI, palpable GB, and thickened GB wall. These findings can aid in pre-operative planning and optimizing patient outcomes.

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Management of the Difficult Gallbladder

Murry,

Babineau

2024

Surgical Clinics of North America

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The Modification of a Preoperative Scoring System to Predict Difficult Elective Laparoscopic Cholecystectomy

Cited by 11 publications

References 19 publications

Predictive Factors for Difficult Laparoscopic Cholecystectomies in Acute Cholecystitis

Predictive Factors for Difficult Laparoscopic Cholecystectomies in Acute Cholecystitis

A prospective study of various pre-operative factors and the development of a scoring system in predicting difficult laparoscopic cholecystectomy

Management of the Difficult Gallbladder

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