Feasibility of Calot’s Triangle Dissection Outcome as Easy versus Difficult Laparoscopic Cholecystectomy Based on Clinico radiological Assessment
Journal Title: Journal of Medical Science And clinical Research - Year 2017, Vol 5, Issue 12
Abstract
Laparoscopic cholecystectomy (LC) is the gold standard treatment for symptomatic cholelithiasis. However conversion is inevitable in difficult cases among all laparoscopic cholecystectomies 1-13% requires conversion to open conversion. Several factors have been implicated with a difficult case, but no reliable criteria are available yet to identify patients preoperatively with a difficult Laparoscopic cholecystectomy in feasibility of Calot’striangle dissection. Aim: To predict the feasibility of Calot’s triangle dissection outcome by clinico-radiological assessment in easy verses difficult laparoscopic cholecystectomy. Material and Methods: This was a prospective study conducted from November 2015 to October 2017. Total of 63 patients meeting the inclusion criteria undergone laparoscopic cholecystectomy were included in the study. Following parameters were assessed preoperatively such as BMI, number of attacks of cholecystitis, previous abdominal surgery, total leucocyte count and compare with intraoperative findings as “easy laparoscopic cholecystectomy” and “difficult laparoscopic cholecystectomy”. The statistical analysis was done using Chi- squretest. Results: Out of 63 patients difficult laparoscopic cholecystectomy was seen in 25 (39.7%) patients and 7 (11.1%) patients required conversion to open cholecystectomy. Significant predictors of difficult and conversion were BMI, TLC, ultrasonographic findings of presence of pericholecystic fluid collection, multiple stone or stones ≥20mm impacted in Hartmann's pouch, adhesion in Calot's triangle and gallbladder perforation. Conclusion: with preoperative clinical and ultrasonographic parameters, proper patients selection can be made to help predict difficult laparoscopic cholecystectomy and a likelihood of conversion to open cholecystectomy. Patients and relatives can be counseled preoperatively for the possibility of difficult operation, prolonged hospital stay and increased cost in predicted difficult case.
Authors and Affiliations
Prof. Dr Braja Mohan Mishra
Keywords
Related Articles
- EP ID EP519560
- DOI -
- Views 81
- Downloads 0
Prospective Study of the Effectiveness of Intramedullary Fixation of Unstable Peritrochanteric Fractures with Interlocking Proximal Femoral Nail
Background: Femur is the longest and strongest bone in the body and one of the principal load bearing in the lower extremity. Fracture of this bone may result in prolonged morbidity and extensive disability unless the tr...
Human Cataract Prevalence in the Non-Coastal Southern Districts of Kerala State
A six year study was undertaken to compare the prevalence of cataract in Kottayam and Pathanamthitta districts of Kerala state, India. Hospital based study was conducted from April 2005 to March 2011 to find out the cata...
Clinical Presentations of Dry Eye in Senior citizens of a tertiary care Eye hospital
Objective: To study Clinical presentations of dry eye in senior citizens of a tertiary care eye hospital Study Design: Hospital based prospective observational study. Materials and Methods: In this hospital based prospec...
Estrogen Receptor α and β Status in Hypertensive Postmenopausal Women with Co-morbidities
Menopause is accompanied by decline in estrogen levels and a substantial rise in the incidence of hypertension in majority of women. Whether this decline is in accordance with estrogen receptor levels and associated como...
Detection of Latent Tuberculosis Infection in Nursing Students by Combined TST and IGRA Serial Testing
Nursing students are Occupationally at risk group for tuberculosis. Tuberculosis can either be as Latent tuberculosis (LTBI) or as active tuberculosis infection (TBI). Lack of awareness and not taking appropriate self de...