TITLE

Preoperative prediction of difficult lap chole: a scoring method

AUTHOR(S)
Randhawa, Jaskiran S.; Pujahari, Aswini K.
PUB. DATE
August 2009
SOURCE
Indian Journal of Surgery;Aug2009, Vol. 71 Issue 4, p198
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Laparoscopic cholecystectomy (LC) has become the procedure of choice for management of symptomatic gallstone disease. At times it is easy and can be done quickly. Occasionally it is difficult and takes longer time. But there is no scoring system available to predict the degree of difficulty of LC preoperatively. To develop a scoring method to predict difficult LC preoperatively. There were 228 cases in 2 years, operated by a single experienced surgeon. There are total 15 score from history, clinical, sonological findings. Score up to 5 predicted easy, 6�10 difficult and >10 are very difficult. Prediction came true in 88.8% for easy and 92% difficult cases there were no cases with score above 10. The factors like BMI > 27.5 (p < 0.010), previous hospitalization (p < 0.001), palpable GB (p < 0.01) US-Thick-walled GB (p < 0.038) are found of statistical significance in predicting difficult LC. The proposed scoring system is reliable with a sensitivity and specificity of 75.00% and 90.24%, respectively.
ACCESSION #
44190891

Tags: LAPAROSCOPY;  CHOLECYSTECTOMY;  GALLSTONES;  HOSPITAL care;  MEDICAL care

 

Related Articles

  • Rate of elective cholecystectomy and the incidence of severe gallstone disease. Urbach, David R.; Stukel, Thérèse A. // CMAJ: Canadian Medical Association Journal;4/12/2005, Vol. 172 Issue 8, p1015 

    Background: The use of elective cholecystectomy has increased dramatically following the widespread adoption of laparoscopic cholecystectomy. We sought to determine whether this increase has resulted in a reduction in the incidence of severe complications of gallstone disease. Methods: We...

  • Evaluation of the Clinical Pathway for Laparoscopic Cholecystectomy and Simulation of Short-term Hospitalization. Yanagi, Ken; Sasajima1,2, Koji; Miyamoto, Masayuki; Suzuki, Seiji; Yokoyama, Tadashi; Maruyama, Hiroshi; Matsutani, Takeshi; Arima, Yasuo; Uchida, Eiji; Tajiri, Takashi // Journal of Nippon Medical School;2007, Vol. 74 Issue 6, p409 

    The effectiveness of the clinical pathway for laparoscopic cholecystectomy was evaluated, and the efficiency of medical care was analyzed. The duration of hospitalization and the number of National Health Insurance (NHI) points for medical service fees were compared between 86 patients treated...

  • Remote Complications of Spilled Gallstones During Laparoscopic Cholecystectomy: Causes, Prevention, and Management. Hawasli, Abdelkader; Schroder, Donn; Rizzo, Joseph; Thusay, Manish; Takach, Thomas J.; Thao, Umeng; Goncharova, Irina // Journal of Laparoendoscopic & Advanced Surgical Techniques;Apr2002, Vol. 12 Issue 2, p123 

    In the last 11 years (November 1989�December 2000), 5526 laparoscopic cholecystectomies were performed in a community residency training program. Two cases (0.04%) of remote complications secondary to spilled gallstones were identified. A 75-year-old woman presented with a sterile abscess...

  • Laparoscopic Cholecystectomy at the Korle Bu Teaching Hospital, Accra, Ghana: An Initial Report. Clegg-Lamptey, J. N. A.; Amponsah, G. // West African Journal of Medicine;Mar2010, Vol. 29 Issue 2, p113 

    BACKGROUND: Laparoscopic cholecystectomy (LC) the preferred treatment for gallstones was not available in Ghana until 2005. OBJECTIVE: To report experience from Ghana of laparoscopic cholecystectomy in the treatment of galestones. METHODS: In a prospective study of patients with gallstones,...

  • The use of laparoscopic subtotal cholecystectomy for complicated cholelithiasis. Philips, J. A. E.; Lawes, D. A.; Cook, A. J.; Arulampalam, T. H.; Zaborsky, A.; Menzies, D.; Motson, R. W. // Surgical Endoscopy;Jul2008, Vol. 22 Issue 7, p1697 

    The risk of damage to the bile duct and structures in the hilum of the liver is significant when Calot�s triangle cannot be safely dissected during laparoscopic cholecystectomy, and conversion to an open procedure often is performed. This is more common during emergency surgery, but may not...

  • Subcapsular Hematoma of the Liver After Laparoscopic Cholecystectomy. Shetty, Geeta S.; Falconer, J. Stuart; Benyounes, Hakim // Journal of Laparoendoscopic & Advanced Surgical Techniques;Feb2005, Vol. 15 Issue 1, p48 

    Two female patients underwent an uneventful laparoscopic chloecystectomy (LC) for cholelithiasis. Their past medical history was insignificant. The first patient had diclofenac sodium for her post-operative pain relief. Both patients returned in the early postoperative period with pain in the...

  • Elective Laparoscopic Cholecystectomy for Symptomatic Gallstone Disease in Patients Receiving Anticoagulant Therapy. Leandros, Emmanuel; Gomatos, Ilias P.; Mami, Panagoula; Kastellanos, Eleftherios; Albanopoulos, Konstantinos; Konstadoulakis, Manousos M. // Journal of Laparoendoscopic & Advanced Surgical Techniques;Aug2005, Vol. 15 Issue 4, p357 

    Background: The safety of laparoscopic cholecystectomy (LC) has been proven in patients with several pre-existing clinical conditions. This study was conducted to evaluate the applicability and safety of elective LC in patients with pre-existing cardiovascular conditions who were receiving...

  • Clipless Laparoscopic Cholecystectomy by Ultrasonic Dissection. Bessa, Samer S.; Al-Fayoumi, Tarek A.; Katri, Khaled M.; Awad, Ahmed T. // Journal of Laparoendoscopic & Advanced Surgical Techniques;Aug2008, Vol. 18 Issue 4, p593 

    Background: Ultrasonically activated devices have been used in gallbladder dissection in the laparoscopic cholecystectomy with encouraging results. The aim of this study was to compare between the safety and efficacy of the harmonic shears and the commonly used clip and cautery technique in...

  • Multilocular Flank Abscess Due to Stone Migration Following Laparoscopic Cholecystectomy with Spillage of Gallstones. Zilbershtein, Sachar; Kessler, Ada; Greenberg, Ron; Skornick, Yehuda; Avital, Shmuel // Journal of Laparoendoscopic & Advanced Surgical Techniques;Aug2006, Vol. 16 Issue 4, p374 

    We report a case of a patient who presented with a large flank abscess 18 months after laparoscopic cholecystectomy. The patient underwent repeated percutaneous drainage but the abscess recurred. Further evaluation with ultrasound revealed subcutaneous tracks from the flank leading to the...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics