Proposed Diagnostic Scoring System to Predict Difficult Laparoscopic Cholecystectomy

Bhondave, Dr S.T.

doi:10.18535/jmscr/v5i12.67

Cited by 4 publications

(16 citation statements)

References 11 publications

(17 reference statements)

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“…In this study, laparoscopic cholecystectomy was performed in 134 patients, and various predictive risk factors for difficult laparoscopic cholecystectomy such as age, gender, history of hospitalization for acute cholecystitis, BMI, abdominal scar, palpable gallbladder, thick gallbladder wall in radiographic finding and leucocyte were analyzed. Each of these risk factors was reported to have a significant effect to predict difficult laparoscopic cholecystectomy by various studies [ 1 , 3 , 4 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…Laparoscopic cholecystectomy has become the preferred method and has been accepted as the gold standard for definitive management of symptomatic cholelithiasis or gallstones [ 1 , 2 ]. This surgical procedure has many advantages over the standard open cholecystectomy, such as minimal trauma, decreased pain, shorter hospital stay, better cosmetic outcome, and faster recovery [ 3 , 4 ]. However, some studies have shown that laparoscopic cholecystectomy has a higher frequency of complications than the standard open cholecystectomy.…”

Section: Introductionmentioning

confidence: 99%

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A Scoring System to Predict Difficult Laparoscopic Cholecystectomy: A Five-Year Cross-Sectional Study

Wibowo

Putra

Noor

et al. 2022

Minimally Invasive Surgery

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Background. Laparoscopic cholecystectomy since long time already has become the preferred method because laparoscopic cholecystectomy has many advantages compared to standard open cholecystectomy. However, since it has associated with a higher risk of complication, preoperative prediction of risk factors is needed to assess the intraoperative difficulties. Various scoring systems have a role in predicting intraoperative difficulties; however, there is a need to find a consistent and reliable predictive system. Aim. To validate a preoperative scoring system that will predict difficult laparoscopic cholecystectomy. Design of the Study. Nonrandomized retrospective descriptive study. Setting. Department of General Surgery, Lambung Mangkurat Univeristy Ulin Referral Hospital, Banjarmasin, Kalimantan Selatan, Indonesia. Methodology. A preoperative score was given to all the patients (134 patients from January 2015–December 2020) based on history, clinical examination, and sonographic findings. Using ROC curve, the cutoff for easy—difficult was 3.5 and difficult—very difficult was 7.5. The scores were compared in each patient to conclude the practicality of the preoperative predictive score. SPSS version 25 was used to analyze the data. Results. History of hospitalization for acute cholecystitis ( p ≤ 0.001 ), high BMI ( p = 0.002 ), abdominal scar ( p = 0.005 ), palpable gallbladder ( p ≤ 0.001 ), thick gallbladder wall ( p ≤ 0.001 ), and leucocyte ( p ≤ 0.001 ) were considered as the significant factors that predict difficult laparoscopic cholecystectomy. Sensitivity and specificity for easy—difficult cutoff of the scoring method were 72.6% and 87.5%, respectively, with the area under the ROC curve being 0.849. Sensitivity and specificity for difficult—very difficult cutoff of the scoring method were 70.0% and 84.5%, respectively, with the area under the ROC curve being 0.779. Conclusion. The preoperative scoring system evaluated in the study is reliable and beneficial in predicting the difficulty of laparoscopic cholecystectomy. However, further randomized prospective multicentric studies with large sample sizes are required to validate the efficiency of the scoring system.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Scoring System to Predict Difficult Laparoscopic Cholecystectomy: A Five-Year Cross-Sectional Study

Wibowo

Putra

Noor

et al. 2022

Minimally Invasive Surgery

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“…Along with the increasing socio-economic conditions of the community, changes in food patterns, and improvements in diagnostic facilities, the prevalence of gallstone disease in developing countries tends to increase. [1][2][3] The incidence of cholelithiasis is 8% in men aged over 40 years and 40% in women over 65 years. 4,5 Most cases require surgery as therapy with laparoscopic cholecystectomy as the preferred method.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, it would be very beneficial if there were specific criteria that could assess operative risk. 3,5,6,[9][10][11][12][13][14][15][16] Several assessment methods have been proposed with various criteria but are still controversial. Considering the risks of surgery and the purpose of obtaining the benefits of surgery for both the patient and the medical team, the authors consider it necessary to raise the topic of a scoring system to predict the difficulty level of laparoscopic cholecystectomy surgery.…”

Section: Introductionmentioning

confidence: 99%

Validation of the Dash, Bhondave, and Gadekar Score System to Predict the Difficulties of Laparoscopic Cholecystectomy

2022

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Background: One of the treatment options for cholelithiasis is laparoscopic cholelithiasis. The challenge of this procedure is to determine the level of surgery. Methods: This analytic cross-sectional study was conducted at Sanglah Hospital Denpasar from January 2019 to September 2020. Several risk factors data were assessed according to the Risk Scoring System for Laparoscopic Cholecystectomy. Receiver Operating Characteristic (ROC) curve was plotted to determine the cut-off score based on the most optimal sensitivity and specificity to predict the difficulty of surgery. Univariate statistical analysis was conducted based on the type of data with a p-value <0.05 considered significant. Results: From a total of 62 laparoscopic cholecystectomies, 36 (58.1%) case was a simple surgery, and 26 (41.9%) was difficult surgery. In the difficult surgical group, 17 surgeries (27.4%) were more than 60 minutes, nine surgeries (14.5%) with bile spillage, and one surgery (1.6%) with ductal injury. The scoring system had a sensitivity of 86.1%, a specificity of 76.9%, a positive predictive value of 83.7%, and a negative predictive value of 80%. Conclusion: A scoring system is a promising approach to estimating the difficulty of laparoscopic cholecystectomy. Further study to improve this scoring system is necessary.

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“…Gall stones and their complications are one of the most common indications for both elective and emergency surgeries whether laparoscopic or open surgery. Laparoscopic cholecystectomy (LC) was first done in 1985, since that time it has widely replaced open cholecystectomy as the standard of care for symptomatic gall stones [ [1] , [2] , [3] , [4] , [5] ].…”

Section: Introductionmentioning

confidence: 99%

Grading operative findings at laparoscopic cholecystectomy following the new scoring system in Duhok governorate: Cross sectional study

Jameel

Bahaddin

Mohammed

2020

Annals of Medicine and Surgery

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Introduction Numerous preoperative scoring systems predict difficult laparoscopic cholecystectomy. Recently, the intraoperative difficulties which are facing surgeons are studied. A new scoring system categorize patients according to many intraoperative findings with a final outcome whether converting to open cholecystectomy or continuing laparoscopically. Patients and methods This prospective study included 120 patients admitted for laparoscopic cholecystectomy for symptomatic gallstones from October 2019 to August 2020. Intraoperative difficulties were evaluated and patients were categorized according to intraoperative scoring for cholecystitis severity and compared depending to the rate of conversion to the open technique. Results Most patient were middle aged females having multiple gallstones, the mean operation time was 35 min and 7.8% of patients were converted to open cholecystectomy because of intraoperative difficulty. There was a significant correlation between the conversion rate and each of distended and/or contracted gall bladder, inability to grasp the gall bladder with traumatic forceps, stone ≥1 cm impacted in Hartman's pouch, and bile or pus outside gallbladder (P values: 0.002, 0.000, 0.008 and 0.015) respectively, and no significant correlation with gallbladder adhesions, adhesions from previous upper abdominal surgery, BMI>30, and Time to identify cystic artery and duct >90 min (P values: 0.123, 1, 1, 0.078) respectively. Conclusion New intraoperative scoring systems are valuable in predicting difficulties and preventing increase operation time and possible injuries. The main points of difficulties are distended or contracted gallbladder, large stone impaction, difficult grasping the wall of the gall bladder and the presence of bile or pus outside the gall bladder.

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Proposed Diagnostic Scoring System to Predict Difficult Laparoscopic Cholecystectomy

Abstract: Background: One of the most common laparoscopic surgeries performed by the general surgeons all over the world is laparoscopic cholecystectomy (LC). Due to various intraoperative difficulties

Cited by 4 publications

References 11 publications

A Scoring System to Predict Difficult Laparoscopic Cholecystectomy: A Five-Year Cross-Sectional Study

A Scoring System to Predict Difficult Laparoscopic Cholecystectomy: A Five-Year Cross-Sectional Study

Validation of the Dash, Bhondave, and Gadekar Score System to Predict the Difficulties of Laparoscopic Cholecystectomy

Grading operative findings at laparoscopic cholecystectomy following the new scoring system in Duhok governorate: Cross sectional study

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