Grading operative findings at laparoscopic cholecystectomy following the new scoring system in Duhok governorate : Cross sectional study
© 2020 The Authors..
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.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:60 |
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| Enthalten in: |
Annals of medicine and surgery (2012) - 60(2020) vom: 01. Dez., Seite 266-270 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Jameel, Sanar Majeed [VerfasserIn] |
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| Links: |
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| Themen: |
Difficult cholecystectomy |
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| Anmerkungen: |
Date Revised 18.04.2022 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1016/j.amsu.2020.10.035 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM317716506 |
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| 100 | 1 | |a Jameel, Sanar Majeed |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Grading operative findings at laparoscopic cholecystectomy following the new scoring system in Duhok governorate |b Cross sectional study |
| 264 | 1 | |c 2020 | |
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| 500 | |a Date Revised 18.04.2022 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © 2020 The Authors. | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Difficult cholecystectomy | |
| 650 | 4 | |a Gallbladder adhesions | |
| 650 | 4 | |a Gallstones | |
| 650 | 4 | |a Intraoperative scoring system | |
| 650 | 4 | |a Laparoscopic cholecystectomy | |
| 650 | 4 | |a Open cholecystectomy | |
| 700 | 1 | |a Bahaddin, Muwafaq Masoud |e verfasserin |4 aut | |
| 700 | 1 | |a Mohammed, Ayad Ahmad |e verfasserin |4 aut | |
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