Prediction of conversion of laparoscopic cholecystectomy to open surgery with artificial neural networks

Gholipour, Changiz; Fakhree, M. Bassir A.; Shalchi, Rosita Alizadeh; Abbasi, Mehrshad

doi:10.1186/1471-2482-9-13

Cited by 43 publications

(52 citation statements)

References 32 publications

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“…Male gender was also evaluated as a risk factor for difficult cholecystectomy (26). Male sex was reported among the risk factors for conversion to open surgery in some previous studies (27)(28)(29)(30).…”

mentioning

confidence: 99%

Laparoscopic partial cholecystectomy: A safe and effective alternative surgical technique in "difficult cholecystectomies"

Kulen¹,

Tıhan²,

Duman³

et al. 2016

UCD

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Objective: Laparoscopic cholecystectomy has become the ''gold standard'' for benign gallbladder diseases due to its advantages. In the presence of inflammation or fibrosis, the risk of bleeding and bile duct injury is increased during dissection. Laparoscopic partial cholecystectomy (LPC) is a feasible and safe method to prevent bile duct injuries and decrease the conversion (to open cholecystectomy) rates in difficult cholecystectomies where anatomical structures could not be demonstrated clearly. Material and Methods:The feasibility, efficiency, and safety of LPC were investigated. The data of 80 patients with cholelithiasis who underwent LPC (n=40) and conversion cholecystectomy (CC) (n=40) were retrospectively examined. Demographic characteristics, ASA scores, operating time, drain usage, requirement for intensive care, postoperative length of hospital stay, surgical site infection, antibiotic requirement and complication rates were compared. Results:The median ASA value was 1 in the CC group and 2 in the LPC group. Mean operation time was 123 minutes in the CC group, and 87.50 minutes in the LPC group. Surgical drains were used in 16 CC patients and 4 LPC patients. There was no significant difference between groups in postoperative length of intensive care unit stay (p=0.241). When surgical site infections were compared, the difference was at the limit of statistical significance (p=0.055). Early complication rates were not different (p=0.608) but none of the patients in the LPC group suffered from late complications. Conclusion:LPC is an efficient and safe way to decrease the conversion rate. LPC seems to be an alternative procedure to CC with advantages of shorter operating time, lower rates of surgical site infection, shorter postoperative hospitalization and fewer complications in high-risk patients.

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mentioning

confidence: 99%

Laparoscopic partial cholecystectomy: A safe and effective alternative surgical technique in "difficult cholecystectomies"

Kulen¹,

Tıhan²,

Duman³

et al. 2016

UCD

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“…Signs of acute cholecystitis were investigated by authors either with clinical signs or laboratory parameters like WBC count. 1,3,4,7,11,13,14 Constantini et al found that a WBC count of greater than 9000 had a statistically significant correlation with conversion whereas Nidoni et al mentioned counts more than 11000 as significant in his study. 1,7 Clinical signs of cholecystitis like pain and fever were found to be significant in prediction of difficulty by all authors, except in study by Constantini et al, where only the elevated WBC count was significant.…”

Section: Clinical Parameters-disease Factorsmentioning

confidence: 82%

“…Gholipour et al and Genc V et al found that intraoperative difficulty and rates of conversion were higher in patients who were operated in emergency those operated in the elective setup. 1,2,6,13 An interesting observation by Randhawa et al in his study states a palpable gallbladder as a significant predictor of intraoperative difficulty. 10 This was one of the unique predictive factor identified by the author.…”

Section: Clinical Parameters-disease Factorsmentioning

confidence: 99%

A comprehensive review of the factors predicting technical difficulty in laparoscopic cholecystectomy

Menon¹

2017

Int Surg J

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Laparoscopic cholecystectomy is the most common laparoscopic procedure performed all over the world. It has now become the gold standard management for symptomatic gallstones. Aim of the study was to identify and highlight the predictive factors determining intra operative technical difficulty in laparoscopic cholecystectomy. A database search was done in Medline, Google scholar and Journal seek using keywords ‘Laparoscopic Cholecystectomy’, ‘difficult cholecystectomy’ and ‘predictive factors’. 54 abstracts were shortlisted out of which 15 were selected based on the time of publication (after 2005), size of study group, relevance to the title, level of evidence and the journal of publication. Results were compared and reviewed and the conclusion was reached. Fifteen papers were reviewed based on literature search and statistically significant variables predicting the technical difficulty in Laparoscopic cholecystectomy was found. These were age, sex, obesity, previous upper abdominal surgeries, comorbid diseases like Diabetes, acute cholecystitis, raised WBC counts, gall bladder wall thickness more than 3mm, presence of pericholecystitic collection, single impacted stone, multiple stones, contracted gall bladder, adhesions at Calot’s triangle, intrahepatic gall bladder, complications like gangrenous GB and fistulisation. The predictive risk factors reviewed here need to be kept in mind by the laparoscopic surgeon during a laparoscopic cholecystectomy. Though none of them is an absolute contraindication, presence of these factors demand modifications in technique for a safe laparoscopic surgery.

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“…This is inconsistent with the previous studies where the conversion rates observed was 3 to 5%. Table12 shows the comparison of conversion rate reported by different studies in different places in the world [24][25][26][27][28][29] . 3) Difficult LC was seen in 40 % patients with previous abdominal surgery and 39.7% patientswithout previous abdominal surgery.…”

Section: Resultsmentioning

confidence: 99%

Feasibility of Calot’s Triangle Dissection Outcome as Easy versus Difficult Laparoscopic Cholecystectomy Based on Clinico radiological Assessment

Mishra¹

2017

jmscr

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Prediction of conversion of laparoscopic cholecystectomy to open surgery with artificial neural networks

Abstract: Background: The intent of this study was to predict conversion of laparoscopic cholecystectomy (LC) to open surgery employing artificial neural networks (ANN).

Cited by 43 publications

References 32 publications

Laparoscopic partial cholecystectomy: A safe and effective alternative surgical technique in "difficult cholecystectomies"

Laparoscopic partial cholecystectomy: A safe and effective alternative surgical technique in "difficult cholecystectomies"

A comprehensive review of the factors predicting technical difficulty in laparoscopic cholecystectomy

Feasibility of Calot’s Triangle Dissection Outcome as Easy versus Difficult Laparoscopic Cholecystectomy Based on Clinico radiological Assessment

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