Prospective validation of the Parkland Grading Scale for Cholecystitis

Madni, Tarik D.; Nakonezny, Paul A.; Barrios, Evan L; Imran, Jonathan B.; Clark, Audra T.; Taveras, Luis R.; Cunningham, Holly B.; Christie, Alana; Eastman, A. Brent; Minshall, Christian T.; Luk, Stephen S.; Minei, Joseph P.; Phelan, Herbert; Cripps, Michael W.

doi:10.1016/j.amjsurg.2018.08.005

Cited by 50 publications

(35 citation statements)

References 31 publications

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“…Our study was compared with Tarik et al [6] According to Tarik et al (p=0.0001), perioperative Gall Bladder status, mean surgery duration (p =0.0001) and mean length of hospital stay (p=0.0001) was found to be same as our study results (p=0.0001) both were statistically significant.…”

Section: Discussionsupporting

confidence: 81%

“…The factors leading to difficult laparoscopic cholecystectomy can be predicted [12] . The accurate and reliable stratification of the severity of gallbladder disease require a grading system which can be easily employed and implemented which further helps in operability, intra & postoperative outcome of the patient [6] . Multiple grading scales have been developed to predict the difficult laparoscopic surgery in which most are based on pre operative clinical findings [9] .…”

Section: Introductionmentioning

confidence: 99%

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Pre-operative evaluation with parkland grading system in assessing difficult laparoscopic cholecystectomy and expectant operative and post-operative complications

Gs¹,

Avinash²,

Bd³

et al. 2019

Int. J. Surg. Sci.

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Pre-operative factors with Parkland grading system in assessing difficult Laparoscopic Cholecystectomy and expectant operative and post-operative complications. Materials and Methods: A prospective study done in hospitals attached to BMC&RI, Department of General Surgery, Bengaluru from Dec 2017-Dec 2018. A total of 110 cases were evaluated & underwent laparoscopic procedure. Gallbladder status was assessed intraoperatively with the application of Parkland grading system.Results: Out of 110 cases-majority were Grade1 (30%), shortest (64.09 mins) & longest surgery duration (152.85 mins) for Grade 1&5 respectively & more complications for Grade 4&5. The length of hospital stay was higher (12.85 days for Grade 5). Conclusion: Parkland grading system is a highly reliable, simple, intra operative based scale that can accurately predict difficult Laparoscopic Cholecystectomy and its outcomes. As the grade increases severity of the disease and difficulty in surgery and its outcomes.

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Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Pre-operative evaluation with parkland grading system in assessing difficult laparoscopic cholecystectomy and expectant operative and post-operative complications

Gs¹,

Avinash²,

Bd³

et al. 2019

Int. J. Surg. Sci.

View full text Add to dashboard Cite

show abstract

“…With the PGS, gallbladder appearance on laparoscopy is rated on a severity scale of 1–5 based on multiple gross findings such as hyperemia, adhesion formation, distention, perforation, or necrosis. Prospective analyses have found that increased severity of grading is significantly associated with increased difficulty of surgery, conversion rates, length of the operation, and incidence of post-operative bile leak [ 14 ]. Notably, gallbladder size is not an included characteristic indicative of such complications.…”

Section: Discussionmentioning

confidence: 99%

Huge gangrenous gallbladder presenting as gastro-esophageal reflux disease successfully treated by laparoscopic cholecystectomy: Case report and literature review

Elkbuli

Meneses

Kinslow

et al. 2020

International Journal of Surgery Case Reports

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Highlights “Giant” gallbladder development in the context of acute on chronic cholecystitis is extremely rare and may present with atypical symptoms secondary to mass effect. Current grading systems for acute cholecystitis severity do not include assessment based on size making them insufficient in predicting “giant” gallbladder surgical prognosis. Laparoscopic cholecystectomy was performed successfully despite the large gallbladder size without intraoperative/postoperative complications.

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“…To use one of these scales, it must be based on intraoperative findings and thus define the difficulty of laparoscopic cholecystectomy, which, regardless of the surgeon, will not change. Given the above, multiple scales such as Parkland, AAST, Cuschieri or Sugrue [8][9][10] have been described, another of these scales were described by Nassar et al, in 1995, which was recently validated in a study that included two prospective cohorts with a total of 12,909 patients. Intraoperative findings are standardized with the help of one of these scales [10].…”

Section: Introductionmentioning

confidence: 99%

Predicting the difficult laparoscopic cholecystectomy based on a preoperative scale

et al. 2022

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It is important to establish the difficulty of a cholecystectomy preoperatively to improve the outcomes. There are multiple risk factors for a difficult cholecystectomy that may depend on the patient, the disease, or extrinsic factors. The aim of this study is to evaluate the predictive capacity of a difficult cholecystectomy with a preoperative scale. A diagnostic trial study was designed to evaluate the performance of a scale to predict the difficulty of laparoscopic cholecystectomy, considering as a reference standard the intraoperative findings evaluated according to an intraoperative difficulty scale. A ROC curve was performed and used to estimate predictive value of the preoperative score to predict the difficulty of a cholecystectomy preoperatively. The ROC curve shows an area of 0.88 under the curve. The calculated ideal cutoff was 8, with a sensitivity, specificity, positive predictive value and negative predictive value of 75.15%, 88.31%, 87.32 and 76.83%, respectively. It was demonstrated that, as the difficulty predicted by the preoperative scale increases, the rate of conversion to open procedure, the rate of subtotal cholecystectomies, the rate of complication and the rate of a critical view of safety failed increase. We suggest implementing the preoperative scale in all patients who are planning laparoscopic cholecystectomy, considering it a simple and easy tool to perform. This to inform the patient, organize the surgery schedule, select personnel, request support and have adequate pre-operative planning. Graphical abstract

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Prospective validation of the Parkland Grading Scale for Cholecystitis

Cited by 50 publications

References 31 publications

Pre-operative evaluation with parkland grading system in assessing difficult laparoscopic cholecystectomy and expectant operative and post-operative complications

Pre-operative evaluation with parkland grading system in assessing difficult laparoscopic cholecystectomy and expectant operative and post-operative complications

Huge gangrenous gallbladder presenting as gastro-esophageal reflux disease successfully treated by laparoscopic cholecystectomy: Case report and literature review

Predicting the difficult laparoscopic cholecystectomy based on a preoperative scale

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