E-ISSN 2367-699X | ISSN 2367-7414
 

Original Research 


Predictors of Difficulty in Laproscopic Cholecystectomy a Retrospective Study from a Tertiary Care Centre of Northern India

Rudramani, Sunil Kumar Singh, Priyanka Rai, Amarjot Singh, Anjani Kumar Tripathi.

Abstract
Introduction: Laparoscopic cholecystectomy (LC) has become the gold standard treatment for the management of symptomatic gall stone disease but a small yet significant number of LC procedures turn out to be difficult during the procedure. Knowledge of factors that can help in predicting the difficulty can help in better preoperative planning.
Aim: To develop and validate a scoring method to predict difficult and very difficult LC preoperatively.
Materials and Methods: This was a retrospective study conducted on medical records of 122 patients with gall stone disease. A quantitative tool based on age, gender, hospitalization history, the clinical and sonographic profile was designed to capture relevant information from these 122 patients postoperatively and was analysed. There was a total score of 21 from history, clinical, sonological findings. A score up to 7 was predicted as easy, 814 as difficult and > 14 as very difficult. The proposed scoring was compared against the laparoscopic difficulty criteria suggested by Randhawa and Pujahari. Data were analyzed using SPSS 21.0 version. Chi-square test and Independent samples t-test were used to compare the data.
Results : History of hospitalization (p < 0.001), history of ERCP with or without stenting(p < 0.001), BMI >27.5 kg/m2 (p = 0.017), abdominal scar (p=0.001), palpable gall bladder(p < 0.001), thickened wall of the gall bladder(p = 0.010), Pericholecystic collection (p=0.005) and raised ALP (p = 0.002) were found to be significantly contributing in predicting the outcome of surgery.
Conclusion: The proposed scoring system was effective and can be helpful in diagnosing preoperatively into easy, difficult and very difficult cases

Key words: Difficult Laparoscopic Cholecystectomy, scoring system, conversion to open cholecystectomy


 
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How to Cite this Article
Pubmed Style

, Singh SK, Rai P, Singh A, Tripathi AK. Predictors of Difficulty in Laproscopic Cholecystectomy a Retrospective Study from a Tertiary Care Centre of Northern India. Int J Surg Med. 2021; 7(4): 43-48. doi:10.5455/ijsm.Laproscopic-Cholecystectomy-79876


Web Style

, Singh SK, Rai P, Singh A, Tripathi AK. Predictors of Difficulty in Laproscopic Cholecystectomy a Retrospective Study from a Tertiary Care Centre of Northern India. http://www.ejos.org/?mno=79876 [Access: November 10, 2021]. doi:10.5455/ijsm.Laproscopic-Cholecystectomy-79876


AMA (American Medical Association) Style

, Singh SK, Rai P, Singh A, Tripathi AK. Predictors of Difficulty in Laproscopic Cholecystectomy a Retrospective Study from a Tertiary Care Centre of Northern India. Int J Surg Med. 2021; 7(4): 43-48. doi:10.5455/ijsm.Laproscopic-Cholecystectomy-79876



Vancouver/ICMJE Style

, Singh SK, Rai P, Singh A, Tripathi AK. Predictors of Difficulty in Laproscopic Cholecystectomy a Retrospective Study from a Tertiary Care Centre of Northern India. Int J Surg Med. (2021), [cited November 10, 2021]; 7(4): 43-48. doi:10.5455/ijsm.Laproscopic-Cholecystectomy-79876



Harvard Style

, Singh, . S. K., Rai, . P., Singh, . A. & Tripathi, . A. K. (2021) Predictors of Difficulty in Laproscopic Cholecystectomy a Retrospective Study from a Tertiary Care Centre of Northern India. Int J Surg Med, 7 (4), 43-48. doi:10.5455/ijsm.Laproscopic-Cholecystectomy-79876



Turabian Style

, Sunil Kumar Singh, Priyanka Rai, Amarjot Singh, and Anjani Kumar Tripathi. 2021. Predictors of Difficulty in Laproscopic Cholecystectomy a Retrospective Study from a Tertiary Care Centre of Northern India. International Journal of Surgery and Medicine, 7 (4), 43-48. doi:10.5455/ijsm.Laproscopic-Cholecystectomy-79876



Chicago Style

, Sunil Kumar Singh, Priyanka Rai, Amarjot Singh, and Anjani Kumar Tripathi. "Predictors of Difficulty in Laproscopic Cholecystectomy a Retrospective Study from a Tertiary Care Centre of Northern India." International Journal of Surgery and Medicine 7 (2021), 43-48. doi:10.5455/ijsm.Laproscopic-Cholecystectomy-79876



MLA (The Modern Language Association) Style

, Sunil Kumar Singh, Priyanka Rai, Amarjot Singh, and Anjani Kumar Tripathi. "Predictors of Difficulty in Laproscopic Cholecystectomy a Retrospective Study from a Tertiary Care Centre of Northern India." International Journal of Surgery and Medicine 7.4 (2021), 43-48. Print. doi:10.5455/ijsm.Laproscopic-Cholecystectomy-79876



APA (American Psychological Association) Style

, Singh, . S. K., Rai, . P., Singh, . A. & Tripathi, . A. K. (2021) Predictors of Difficulty in Laproscopic Cholecystectomy a Retrospective Study from a Tertiary Care Centre of Northern India. International Journal of Surgery and Medicine, 7 (4), 43-48. doi:10.5455/ijsm.Laproscopic-Cholecystectomy-79876