Sonography for Selecting Candidates for Laparoscopic Cholecystectomy

Dinkel, Hans-Peter; Kraus, Simon; Heimbucher, J.; Moll, Roland; Knüpffer, Joachim; Gassel, H.‐J.; Freys, S. M.; Fuchs, Karl–Hermann; Schindler, G.

doi:10.2214/ajr.174.5.1741433

Cited by 27 publications

(22 citation statements)

References 23 publications

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“…The identification of parameters predicting conversion helps in preoperative patient counseling, provides for better perioperative planning and avoids laparoscopy associated complications by converting to open procedure as and when appropriate. [12][13][14][15] In our study it has been observed 16 In 1994, Fried, et al published a study suggesting that the most significant predictors of conversion were increasing age, obesity, thickened gallbladder wall by pre-operative ultrasound and acute cholecystitis. Male sex was also one of them.…”

supporting

confidence: 54%

Risk factors influencing conversion of laparoscopic cholecystectomy to open cholecystectomy

et al. 2017

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Background: Gall stone disease is a common disease affecting human beings. Over the past two decades, laparoscopic cholecystectomy has become gold standard for the surgical treatment of gallbladder disease. The advantages of laparoscopic cholecystectomy over open surgery are a shorter hospital stay, less postoperative pain, faster recovery, better cosmoses. This study was planned to identify the circumstances and the risk factors influencing the conversion of laparoscopic cholecystectomy to open procedure.Methods: This is a Prospective study conducted over a period of 24 months. A total of 50/500 patients who were electively posted for laparoscopic cholecystectomy and got converted into open cholecyctectomy were included in the study. The Factors recorded and analysed were Age and Sex of the patient, presence of diabetes mellitus, previous episode of Acute Cholecystitis, Body Mass Index, presence of abdominal scar, total count, Ultrasonagram Abdomen findings of Gallbladder wall thickness and presence of pericholecystic fluid.Results: In our study, it has been observed that Patient Related Factors - Age >50yrs, Male gender, Presence of Diabetes Mellitus, Obesity, previous Abdominal surgeries and Disease Related Factors - previous episode of Acute Cholecystitis, presence of Acute Cholecystitis, Gallbladder wall thickness >4mm, presence of Pericholecystic fluid were found to be significant risk factors in conversion of laparoscopic to open cholecystectomy.Conclusions: These risk factors help to predict the difficulty of the procedure and this would permit the surgeon to better inform patients about the risk of conversion from laparoscopic to open cholecystectomy.

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confidence: 54%

Risk factors influencing conversion of laparoscopic cholecystectomy to open cholecystectomy

et al. 2017

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“…(12) Contracted Gallbladder In our study, we observed that laparoscopic cholecystectomy was difficult in all 7 patients with contracted gallbladder. Though statistically insignificant may be because of small number of cases, contracted gallbladder with thick-walled gallbladder is a strong predictor of difficult laparoscopic cholecystectomy (p value 0.001).…”

Section: Gallstone (Biliary) Pancreatitismentioning

confidence: 59%

Preoperative Predictors of Difficult Laparoscopic Cholecystectomy: A Prospective Study

Verma¹,

Singh²,

Kala³

et al. 2016

jemds

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BACKGROUNDPreoperative difficulty estimation helps deciding whether to proceed with a minimally invasive approach, perform an open procedure or make a referral to a more experienced surgeon. Laparoscopic cholecystectomy outcome is particularly affected by the presence and severity of inflammation, age, male sex, etc.To determine the preoperative predictive factors for difficult laparoscopic cholecystectomy. MATERIAL AND METHODSA total of 100 patients were enrolled to this study. Clinical examination, laboratory data and ultrasound study was performed for all patients. CONCLUSIONPreoperative prediction of risk factors of difficult laparoscopic cholecystectomy is an important point for operative planning and the high risk patients may be informed accordingly.

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“…[18,19] In contrast, study done by Sharma et al found that management of patients by OC was done in up to 45% of patients.. [20] Bingener et al reported managing 5.2% of the patients by open surgery. [21] Ishizaki et al and Gence et al reported managing 7.5% & 3.16% of patients by open surgery respectively. [22,23] The leading cause for management of patients by open surgery was presence of adhesions in our study.…”

Section: Discussionmentioning

confidence: 98%

Role of Ultrasonography (USG) in Evaluation of Pericholecystic Adhesions in Gallstone Disease (GSD)

Wani¹,

Rastogi²,

Pratap³

et al. 2017

Ann. Int. Med. Den. Res.

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Background: In the recent era of laparoscopic and robotic surgeries, preoperative imaging has become very crucial in selecting the right operative technique in any pathological condition. Though laparoscopic cholecystectomy is widely accepted and practiced surgical technique yet it has limitations especially dense pericholecystic adhesions where the surgeon requires larger field of view for optimal dissection of gall bladder bed and for optimal control of bleeding. Though ultrasonography has been in wide use for preoperative evaluation of gall bladder stone disease yet very few studies have been conducted to evaluate its role in predicting pericholecystic adhesions responsible for difficult laparoscopic cholecystectomy. Prior knowledge of dense pericholecystic adhesions may help the surgeon in opting for open over laparoscopic cholecystectomy. Methods: Out of 70 patients with gall bladder stone disease that were enrolled in the study, complete data could be obtained in only 55 patients. All patients included in the study underwent ultrasonography of abdomen in fasting state and findings were recorded including pericholecystic adhesions & visualisation of Calot's triangle. The ultrasonographic findings were compared with that of the operative findings. Results: Our study revealed that ultrasonography has more than 70% sensitivity, more than 80% specificity and more than 76% accuracy in predicting pericholecystic adhesions which is the major cause of conversion from laparoscopic to open cholecystectomy. Conclusions: Ultrasonography can serve as an inexpensive imaging tool for predicting difficult laparoscopic cholecystectomy in patients with gall bladder stone disease by demonstrating signs of pericholecystic adhesions and nonvisualisation of normal-appearing Calot's triangle.

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Sonography for Selecting Candidates for Laparoscopic Cholecystectomy

Cited by 27 publications

References 23 publications

Risk factors influencing conversion of laparoscopic cholecystectomy to open cholecystectomy

Risk factors influencing conversion of laparoscopic cholecystectomy to open cholecystectomy

Preoperative Predictors of Difficult Laparoscopic Cholecystectomy: A Prospective Study

Role of Ultrasonography (USG) in Evaluation of Pericholecystic Adhesions in Gallstone Disease (GSD)

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