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 99
- Downloads 0
A Comparative Study between nasal endoscopy and CT PNS in evaluation of chronic nasal obstruction
Introduction: Nasal obstruction is defined as sensation of insufficient airflow through the nose. Nasal obstruction may be the cardinal presenting symptom of many common disease processes, such as rhinitis, sinusitis, se...
Hemorrhagic effusions in pleural tuberculosis: Need for correlation with pleural biopsy histopathological patterns
Pleural tuberculosis is a major treatable cause of exudative pleural effusions in India. Rarely these patients present with hemorrhagic effusion. Due to the similar constitutional symptoms, it becomes important to rule o...
Pattern of male genitourinary cancer
Background: The genitourinary cancer accounts for the largest group of male cancers even more than the head and neck cancers. Cancer data from Rajasthan are limited. Aim: To determine the pattern of male genitourinary ca...
Study of correlation of Visual Field Index and stages of diabetic retinopathy
Aim: To study correlation between VFI and Diabetic Retinopathy. Material and Methods: This study was done in Dept of Ophthalmology in tertiary care hospital. 100 known diabetic patients were included in this study. Detai...
Foetal macrosomia: a case report
Introduction: Foetal macrosomia is defined conventionally as newborn weight exceeding 4000gm. various maternal and foetal factors predispose to foetal macrosomia. The incidence of foetal macrosomia is increasing and has...