Awad, E., Abdel Rahim, M., Hassan, A. (2021). Predictive Factors of Difficult Laparoscopic Cholecystectomy. The Egyptian Journal of Hospital Medicine, 82(1), 67-73. doi: 10.21608/ejhm.2021.137933
Esmail Tharwat Kamel Awad; Mohammed Abdel Fattah Abdel Rahim; Ahmed Mohamed Hassan. "Predictive Factors of Difficult Laparoscopic Cholecystectomy". The Egyptian Journal of Hospital Medicine, 82, 1, 2021, 67-73. doi: 10.21608/ejhm.2021.137933
Awad, E., Abdel Rahim, M., Hassan, A. (2021). 'Predictive Factors of Difficult Laparoscopic Cholecystectomy', The Egyptian Journal of Hospital Medicine, 82(1), pp. 67-73. doi: 10.21608/ejhm.2021.137933
Awad, E., Abdel Rahim, M., Hassan, A. Predictive Factors of Difficult Laparoscopic Cholecystectomy. The Egyptian Journal of Hospital Medicine, 2021; 82(1): 67-73. doi: 10.21608/ejhm.2021.137933
Predictive Factors of Difficult Laparoscopic Cholecystectomy
General Surgery Department, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
Abstract
Background: Laparoscopic cholecystectomy is considered the gold standard treatment of symptomatic cholelithiasis, preoperative prediction of the difficult surgery is an important aspect of planning laparoscopic surgery. Objective: The purpose of this prospective study is to evaluate, analyze, and document different predictive factors of difficult laparoscopic cholecystectomy and whether conversion rate to open surgery and complications can be minimized during laparoscopic cholecystectomy. Patients and Methods: This is a prospective clinical study done on 100 patients complaining of calcular cholecystitis admitted to having (LC) at the Department of Surgery Faculty of Medicine Al-Azhar University Hospital in Assiut and Al-Arish General Hospital from May 2018 to January 2020. Results: Univariate analysis of pre-operative risk factors versus operative data variables showed that male gender was associated with prolonged operative time. Age above 45 years was associated with prolonged dissection time, GB bed dissection time. BMI of 30 or more was associated with prolonged GB bed dissection time. Palpable GB was associated with prolonged operative time, prolonged GB bed dissection time, prolonged GB extraction time, and increased risk for conversion to open surgery. Distended GB in ultrasound was associated with prolonged operative time. Solitary stone in GB was associated with prolonged extraction time. Conclusion: Pre-operative factors can help to predict a difficult LC. This information may be useful to both the patient and the treating surgeon. Prediction of a difficult procedure would allow the surgeon to discuss the likelihood of conversion with the patient and prepare him/her psychologically as well as planning their recovery and explaining their absence from work.
View on SCiNiTO
Top