Hanna, H., Mohamed, M., Nazier, A. (2018). Preoperative Prediction of Difficulty of Laparoscopic Cholecystectomy. The Egyptian Journal of Hospital Medicine, 73(2), 6097-6102. doi: 10.21608/ejhm.2018.12525
Hanna Habib Hanna; Mohamed Ibrahim Mohamed; Amir Milad Nazier. "Preoperative Prediction of Difficulty of Laparoscopic Cholecystectomy". The Egyptian Journal of Hospital Medicine, 73, 2, 2018, 6097-6102. doi: 10.21608/ejhm.2018.12525
Hanna, H., Mohamed, M., Nazier, A. (2018). 'Preoperative Prediction of Difficulty of Laparoscopic Cholecystectomy', The Egyptian Journal of Hospital Medicine, 73(2), pp. 6097-6102. doi: 10.21608/ejhm.2018.12525
Hanna, H., Mohamed, M., Nazier, A. Preoperative Prediction of Difficulty of Laparoscopic Cholecystectomy. The Egyptian Journal of Hospital Medicine, 2018; 73(2): 6097-6102. doi: 10.21608/ejhm.2018.12525
Preoperative Prediction of Difficulty of Laparoscopic Cholecystectomy
Department of General Surgery, Faculty of Medicine, Ain Shams University
Abstract
Background: laparoscopic cholecystectomy (LC), one of the most commonly performed surgical procedures worldwide, is accepted as the gold standard in the treatment of symptomatic gallstones for its minimal invasiveness, less pain and early recovery. Purpose: to predict the difficulty of laparoscopic cholecystectomy in patients according to the recently published scoring system and to add more items to it. Patients and Methods: this is a prospective cohort study. This study took place in Ain Shams University Hospital and Manshiet El Bakry Public Hospital, General Surgery Unit, Surgery Department; the study involved 120 patients admitted with calcular cholecystitis, arranged for laparoscopic cholecystectomy. Results: in our study we found that age, sex and ultrasonographic data were significant predictive factors for assessment preoperatively difficult cases that will be operated upon. We found 14 patients above 50 years who scored to be difficult and very difficult were at outcome difficult, only three patients converted to open surgery over fifty. Conclusion: According to sex males has been described to be associated with difficult LC as in our study that confirmed that as 14 males who participated in our study 10 of them were predicted to have a difficult surgery and 3 expected to be very difficult. Post-surgery 100% of males turned out to have a difficult procedure. Also according to other factors, such as history of acute attacks that increase risk and difficulty due to adhesions at Calot`s triangle and risk of cystic artery and bile spillage, were increased during dissection.
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