EVALUATION OF VARIOUS PRE-OPERATIVE PARAMETERS FOR PREDICTION OF DIFFICULT LAPAROSCOPIC CHOLECYSTECTOMY
Journal Title: Journal of Advanced Medical and Dental Sciences Research - Year 2017, Vol 5, Issue 3
Abstract
Background: Cholecystectomy is one of the commonest surgical procedures performed throughout the world. Various parameters like age, sex, body mass index (BMI), history of previous abdominal surgery, ultrasonography findings of gall bladder wall, Routine Investigations and Ultrasonography of the abdomen. Patient of all ages and both gender were included in the study. Detail medical history of all patients were recorded, demographic data like age, sex, weight, height and body mass index (BMI) were measured before the surgery. Heamatological blood investigations were done prior to surgery. Special emphasis were given to total leukocyte count (TLC), Alkaline phosphatase (ALP), S.Bilirubin, and liver enzymes. Ultrasonography of the abdomen was done in all patients before surgery and various parameters were recorded. After the surgery, patients were group thickness, contracted gall bladder, peri-cholecystic fluid, size of stone and haematological findings like raise total leucocytes count, alkaline phosphatase; liver enzymes were added in recent studies to predict difficult Laparoscopic Cholecystectomy. This study was conducted to analyse whether these parameters could be used pre-operatively for prediction of difficult laparoscopic cholecystectomy and conversion. Materials & methods: The present study included patients who attended the Outdoor Patient Department (OPD) with history of symptomatic Gallstone Disease were enrolled and elective surgery was performed after clinical assessmentinto 2 categories; those who had a successful laparoscopic cholecystectomy, those cases who had conversion to open cholecystectomy Laparoscopic cholecystectomy was performed in all the patients. All the results were recorded and analyzed by SPSS software. Results: Age > 50 years was associated with risk of conversion/difficult laparoscopic cholecystectomy. Sensitivity was 95.9% with a positive predictive value of 95%. Conversion rate among male was 27.7% where as in female it was 8.5%. Body Mass Index (BMI) > 30 kg/m2 had a significant co-relation with risk of conversion to open cholecystectomy Sensitivity was 96.9% and positive predictive value was 94.1%. p value was 0.000, the conversion rate among cases with BMI >30 kg/m2 was 70%. Conclusion: Parameters like age, sex, obesity, history of upper abdominal surgery, raised total leucocytes count etc. are risks factors and predictors for conversion to open cholecystectomy.
Authors and Affiliations
Ashwani Kumar, Ashish Chabra, Bharat Bhushan
Keywords
Related Articles
- EP ID EP557782
- DOI -
- Views 112
- Downloads 0
A cause and effect relationship between pediatric epileptic medications and vitamin - D deficiency: Does it exist?
Objective: Epilepsy is included in neurological disorders that require chronic therapy using antiepileptic medications. Short term follow ups have implicated that patients’ on antiepileptic drugs use for long duration ma...
Evaluation and comparison of the effect of denture cleansers on tensile strength of silicone based resilient liner attached to heat cured denture base material – An in vitro study
Purpose: To evaluate the tensile bond strength of silicone-based resilient liners attached to heat cured denture base material, when treated with different denture cleansing solutions. Materials and Methods: Sixty cylin...
Giant Cell Fibroma of Palate- A Case Report
Giant cell fibroma a variant of oral fibroma, is a rare reactive fibrous connective tissue tumour of the oral cavity. Different forms of fibrous hyperplasia share a similar clinical features, age, site and gender predile...
CLINICAL AND RADIOGRAPHICAL SIGNS IN PATIENTS WITH SPINAL TUBERCULOSIS- A CLINICAL STUDY
Background: TB is presently a global epidemic with over two billion people, equal to one third of the world’s population currently estimated to be infected, with 8.8 million new TB cases identified worldwide and 1.4 mill...
Clinical and Bacteriological Profiles of Early Onset Infection in Hospital Delivered Babies
Background: Neonatal septicemia is a common cause of morbidity and mortality in developing countries. A wide variety of bacteria may be responsible for early onset septicaemia in neonates. Prompt identification of bacter...