A Clinico-Radiological Study to Determine the Predictive Factors for Difficult Laparoscopic Cholecystectomy
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 12
Abstract
BACKGROUND: Pre-operative prediction of a difficult laparoscopic cholecystectomy(LC) can help the patient as well as the surgeon to prepare better for the intra-operative risk of LC and to reduce the risk of conversion to open procedure. METHODS: 65 patients who underwent LC from January 2017 to june 2018 in B S Medical College and Hospital, Bankura, were taken in this study group. For this study the pre-operative difficulty was predicted using scoring system, obtained from parameters like age, sex, BMI, severity of attack, h/o previous lower abdominal surgery and ultrasonography findings. RESULT: most of the patients in this study were between 31-45 yrs of age and majority was female. Out of 65 patients, easy LC predicted on the basis of pre-operative variables were 44. Among them 9 patients predicted to have easy LC but found to be difficult. 18 patients were predicted to have difficult LC preoperatively. Among them 2 patients were found to had easy LC.This scoring system can predict difficult cases with 89% accuracy and easy cases with 80% accuracy. CONCLUSION: Sex, BMI , severity of attack, gallbladder wall thickness are good predictive factors for preoperative assessment of difficult LC.
Authors and Affiliations
Dr Suman Singh, Dr Amit Kumar Das, Dr Arunava Ghosh
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