Factors Associated with Successful Laparoscopic Cholecystectomy for Acute Cholecystitis

Rattner, David W.; Ferguson, Charles M.; Warshaw, Andrew L.

doi:10.1097/00000658-199303000-00003

Cited by 207 publications

(149 citation statements)

References 8 publications

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“…History of hospitalization due to episodes of cholecystitis has a correlation with the difficulty level of cholecystectomy as it may lead to increased gall bladder wall thickness and causing scarring and fibrosis of gall bladder. 8 In the present study, we found strongly significant correlation between previous history of hospitalization and difficult LC. In study by Randhawa and Pujahari, clinically palpable gall bladder was found to be a predictor of difficult laparoscopic cholecystectomy but in the present study, only 2 patients had clinically palpable GB and both had a difficult procedure during surgery.…”

Section: Discussionsupporting

confidence: 65%

Preoperative prediction of difficult laparoscopic cholecystectomy using a scoring system

Khetan

Yeola

2017

Int Surg J

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Background: Laparoscopic cholecystectomy (LC) has become gold standard for the surgical treatment of gallbladder disease. 2% to 15% of patients require conversion to open surgery for various reasons. Pre-operative prediction of “difficult laparoscopic cholecystectomy” may not only improve patient safety but also be useful in reducing the overall cost of therapy. The aim of this study is to study the factors determining the preoperative predictability of difficult laparoscopic cholecystectomy.Method: 30 cases of laparoscopic cholecystectomy operated by a single experienced surgeon. There are total 15 score from history, clinical and sonological findings. They were evaluated and scored on the basis of scoring system of Randhawa and Pujahari. Score up to 5 is defined as easy, 6-10 as difficult and 11-15 as very difficult.Result: Previous history of hospitalization for cholecystitis and increased gall bladder wall thickness were found statistically significant in predicting difficult LC.Conclusion: The scoring system had a positive prediction value for easy prediction of 81.9% and for difficult prediction of 75%.

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Section: Discussionsupporting

confidence: 65%

Preoperative prediction of difficult laparoscopic cholecystectomy using a scoring system

Khetan

Yeola

2017

Int Surg J

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“…It is well-known that the rate of wound infection, bile leaks, CBD injury, and cardiopulmonary complications is lower in LPC than in open surgery. [22] Also, the median duration of hospitalization in open surgery is 3-10 days; [23][24][25][26] our median duration of hospitalization was 3.25 days (2-11 days).…”

Section: Discussionmentioning

confidence: 79%

Technical solutions for difficult laparoscopic cholecystectomies: Fundus-first technique and partial cholecystectomy

Sormaz

Soytaş²,

Gök³

et al. 2017

Ulus Travma Acil Cerrahi Derg

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“…Several studies have shown that performing LC within 72 h of presentation does not increase morbidity and mortality [6,9] . Early LC, furthermore, has been shown to have a lower complication rate, decreased length of stay, decreased cost, and a shorter post-operative recovery period compared to delayed LC [5,7,8,16,17] . The results from a meta-analysis by Papi et al of 12 prospective randomized trials from 1970-2000 (9 addressing open cholecystectomy, 3 addressing LC), showed that there was a decrease in conversion to open procedure when LC was done early (17.6% vs 25.7%) and there were fewer post-operative complications (10.9% vs 15.6%) [17] .…”

Section: Discussionmentioning

confidence: 99%

“…Initially there was concern about potential dangers of performing an operation on an acutely inflamed gallbladder with instruments that lacked the feedback, dexterity, and precision of human hands [3,4] . Studies within the past ten years, however, have determined that laparoscopic cholecystectomy for patients with acute cholecystitis within three days of admission is not only safe but also associated with fewer post-operative complications, decreased morbidity, decreased length of hospital stay, and decreased overall cost when compared to delayed or interval LC [5][6][7][8][9] . Cognizance of the general preferability of prompt surgery, however, may not be uniform among all caretakers.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with time to laparoscopic cholecystectomy for acute cholecystitis

Daniak

Peretz²,

Fine³

et al. 2008

WJG

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AIM:To determine patient and process of care factors associated with performance of timely laparoscopic cholecystectomy for acute cholecystitis. METHODS:A retrospective medical record review of 88 consecutive patients with acute cholecystitis was conducted. Data collected included demographic data, co-morbidities, symptoms and physical findings at presentation, laboratory and radiological investigations, length of stay, complications, and admission service ( m e d i c a l o r s u r g i c a l ) . Pa t i e n t s n o t u n d e r g o i n g cholecystectomy during this hospitalization were excluded from analysis. Hierarchical generalized linear models were constructed to assess the association of pre-operative diagnostic procedures, presenting signs, and admitting service with time to surgery. RESULTS:Seventy cases met inclusion and exclusion criteria, among which 12 were admitted to the medical service and 58 to the surgical service. Mean ± SD time to surgery was 39.3 ± 43 h, with 87% of operations performed within 72 h of hospital arrival. In the adjusted models, longer time to surgery was associated with number of diagnostic studies and endoscopic retrograde cholangio-pancreatography (ERCP, P = 0.01) as well with admission to medical service without adjustment for ERCP (P < 0.05). Patients undergoing both magnetic resonance cholangiopancreatography (MRCP) and computed tomography (CT) scans experienced the longest waits for surgery. Patients admitted to the surgical versus medical service underwent surgery earlier (30.4 ± 34.9 vs 82.7 ± 55.1 h, P < 0.01), had less postoperative complications (12% vs 58%, P < 0.01), and shorter length of stay (4.3 ± 3.4 vs 8.1 ± 5.2 d, P < 0.01). CONCLUSION:Admission to the medical service and performance of numerous diagnostic procedures, ERCP, or MRCP combined with CT scan were associated with longer time to surgery. Expeditious performance of ERCP and MRCP and admission of medically stable patients with suspected cholecystitis to the surgical service to speed up time to surgery should be considered.

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Factors Associated with Successful Laparoscopic Cholecystectomy for Acute Cholecystitis

Abstract: Laparoscopic cholecystectomy for acute cholecystitis should be done immediately after the diagnosis is established because delaying surgery allows inflammation to become more intense, thus increasing the technical difficulty of laparoscopic cholecystectomy.

Cited by 207 publications

References 8 publications

Preoperative prediction of difficult laparoscopic cholecystectomy using a scoring system

Preoperative prediction of difficult laparoscopic cholecystectomy using a scoring system

Technical solutions for difficult laparoscopic cholecystectomies: Fundus-first technique and partial cholecystectomy

Factors associated with time to laparoscopic cholecystectomy for acute cholecystitis

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