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A prospective study on clinico-radiological factors predicting difficult laparoscopic cholecystectomy in our institute

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Original Article

Author Details : Zeeshan Khalid*, Pankaj Kumar, Shagufta Ali

Volume : 6, Issue : 4, Year : 2024

Article Page : 114-120

https://doi.org/10.18231/j.jsas.2024.026

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Abstract

Aim and Objectives: To assess clinical and radiological factors that predict difficult laparoscopic cholecystectomy.
Background: Laparoscopic cholecystectomy is a complex surgical procedure involving anatomical variations, adhesions, and gall bladder contracting. Preoperative assessment is crucial for identifying risks and improving post-operative outcomes. The study identifies clinico-radiological factors predicting difficult laparoscopic cholecystectomy, improving preoperative planning, reducing conversion rates, and optimizing surgical preparedness and patient counseling for safer, more efficient practices.
Materials and Methods: A prospective observational study was conducted at the Department of General Surgery, Integral Institute of Medical Sciences and Research in Lucknow, involving 90 patients selected for Elective Laparoscopic Cholecystectomy and those with ultrasonographic ally proven cholelithiasis, excluding those with significant co-morbid illnesses or not fit for pneumoperitoneum creation. The study utilized IBM SPSS Stats 25.0 software for data analysis, presenting continuous data as mean±standard deviation and categorical/qualitative data as numbers and percentages.
Results: Total 90 patients aged 15-70, with a majority female (77.8%), and a mean BMI of 18.5-30.0 kg/m2, with 48 patients under 25 kg/m2. A pre-operative scoring system for difficult laparoscopic cholecystectomy was developed using demographic, clinical, laboratory, and USG findings. The system ranged from 0-5 to 11-15 difficult surgeries, with a mean predictive score of 0-7. Most surgeries were predicted as easy, followed by difficult (18.9%) and very difficult (5.6%). Factors like age, BMI, hospitalization history, comorbidities, and abdominal scars were associated with ease of surgery.
Conclusions: The study assessed 90 patients aged 15-70 for difficult laparoscopic cholecystectomy procedures using a difficulty predicting scoring system, identifying factors like age, sex, hospitalization history, and BMI.

Keywords: Laparoscopic cholecystectomy, USG, Fibrinogen

How to cite : Khalid Z, Kumar P, Ali S, A prospective study on clinico-radiological factors predicting difficult laparoscopic cholecystectomy in our institute. IP J Surg Allied Sci 2024;6(4):114-120

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