Prediction of Difficult Laparoscopic Cholecystectomy Based on Clinical and Ultrasonographic Parameters

Ambuj Kumar Soni; Yogesh Kailasia; Priyank Sharma; B Y Darshan

Ambuj Kumar Soni Shyam Shah Medical College, Rewa, Madhya Pradesh, India
Yogesh Kailasia Shyam Shah Medical College, Rewa, Madhya Pradesh, India,
Priyank Sharma Shyam Shah Medical College, Rewa, Madhya Pradesh, India
B Y Darshan Shyam Shah Medical College, Rewa, Madhya Pradesh, India

Keywords: Conversion,, Difficulty,, Laparoscopic cholecystectomy, Open cholecystectomy

Abstract

Background: Cholelithiasis is the most common biliary pathology. The definitive treatment for cholelithiasis is either open/laparoscopic cholecystectomy (LC). The objective of this study was to predict difficulty in doing LC based on clinical and ultrasonographic parameters.
Materials and Methods: A hundred patients admitted with a diagnosis of cholelithiasis in surgical wards in the Department of Surgery, Shyam Shah Medical College and Associated Sanjay Gandhi Memorial Hospital, Rewa, from June 1, 2018, to May 31, 2019, were included in the study. All necessary investigations were carried out. X-ray, ultrasonography (USG) abdomen, and blood investigations were done. Patients underwent LC, and a careful record of pre-operative and post-operative findings was made and carefully filled in the pro forma.
Results: In the present study, body mass index >27.5 kg/m2 (27%) shows a correlation with predicting difficult LC and conversion to open procedure. Clinical parameters such as guarding and rigidity (8%) with mass (12%) were a sign of acute inflammation, associated with ultrasonography findings favor for difficult cholecystectomy. Gallbladder wall thickness (38%) and pericholecystic fluid collection (16%) in USG are strong predictors of difficulty.
Conclusion: Clinical and USG findings help to predict difficulty in laparoscopic cholecystectomy and leading to the conversion of LC to open cholecystectomy

Author Biographies

Ambuj Kumar Soni, Shyam Shah Medical College, Rewa, Madhya Pradesh, India

RSO, Department of Surgery,

Yogesh Kailasia, Shyam Shah Medical College, Rewa, Madhya Pradesh, India,

Associate Professor, Department of Surgery,

Priyank Sharma, Shyam Shah Medical College, Rewa, Madhya Pradesh, India

Professor, Department of Surgery,

B Y Darshan, Shyam Shah Medical College, Rewa, Madhya Pradesh, India

RSO, Department of Surgery,

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