Assessment of risk factors for difficult surgery in laparoscopic cholecystectomy
Journal Title: MedPulse -International Medical Journal - Year 2017, Vol 4, Issue 2
Abstract
Background: Laparoscopic cholecystectomy (LC) may be rendered difficult by various problems encountered during surgery. Prediction of a difficult LC would allow the surgeon to discuss the likelihood of conversion with the patient and prepare the patient psychologically as well as planning their recovery and explaining their absence from work. This study aim to assess the preoperative factors for prediction of difficulty of LC and the possibility of conversion to open cholecystectomy before surgery using the clinical, pathological and ultrasonological criteria. Material and Methods: This study was carried out on 60 patients with symptomatic cholelithiasis, normal liver function tests and non-dilated bile ducts scheduled for LC. Age, sex, body mass index, previous abdominal surgery and past history of acute attack of cholecystitis of the patients were recorded. Apre-operative ultrasound was performed along with routine blood investigations. Results: Overall conversion rate was 3.3%. Univariate analysis showed that sex, fever at the time of attack, gall bladder wall thickness, pericholecystic collection on ultrasonography, raised liver function test and total leucocyte count were significant for conversion. Discussion: It is possible to predict the risk of conversion and patients can be informed preoperatively. Patients with a high preoperative factors for prediction of difficult LC may allow the surgeon to take an early decision to convert to OC when difficulty is encountered during dissection; this may shorten the duration of surgery and decrease the associated morbidity.
Authors and Affiliations
Vijay Kassa, Rajnish Jaiswal
Keywords
Related Articles
- EP ID EP176316
- DOI -
- Views 105
- Downloads 0
Rare case of caesarean scar pregnancy
This case illustrates the importance of considering a diagnosis of ectopic pregnancy at previous caesarean scar. When a live intrauterine pregnancy consisting of gestational sac, fetal pole and or yolk sac cannot be visu...
Ocular Masquerade syndrome
Masquerade syndromes comprises a group of disorders simulating a chronic idiopathic uveitis, having an underlying primary cause that is not immune mediated and that is associated with an apparent clinical picture of intr...
Effect of highly active antiretroviral therapy (HAART) in coping the psychiatric patterns in a tertiary care hospital in Raichur
Coping is defined as the cognitive or behavioural strategies used to manage demands that are perceived to exceed existing resources. They further described coping strategies as either problem-focused (aimed at removing,...
Oral pleasure-oral sexually transmitted infections-oral cancer: A missing link
Many men and women find oral sex an intensely pleasurable experience. People use different terms to refer to oral sex (including formal terms like fellatio and cunnilingus and slang terms like blow jobs and giving head)....
Scrotal neoplasms: A histopathological study
Background: Testicular tumours are a heterogenous group of neoplasms with variable histopathology, clinical course and prognosis. A wide range of histologic types of testicular tumours are recognized, the majority of whi...