17Jul 2017

SCORING SYSTEM FOR PREDICTING RISK FACTORS FOR DIFFICULT LAPAROSCOPIC CHOLECYSTECTOMY.

  • Al-Fallouja Teaching Hospital, Al-Fallouja, Iraq.
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Laparoscopic cholecystectomy proved to be the gold standard in the treatment of cholelithiasis and is replacing open cholecystectomy. The rate of conversion from laparoscopic cholecystectomy to open cholecystectomy range from 5-10 %, that's why it is necessary to study the predictive factors for difficult laparoscopic cholecystectomy. 115 patients were all subjected to ultrasonographic examination. The patients confirmed by US examination are evaluated with following factors: age, sex, BMI, h/o previous hospitalization, h/o previous abdominal surgeries, h/o acute cholecystitis. Ultrasonographic findings were Gall bladder wall thickness (> or < 4mm), pericholecystic fluid collection, number (solitary versus multiple) and liver texture (normal, fatty infiltration or fibrosis). Following evaluation the patients were subjected to laparoscopic cholecystectomy and the following operative parameters were assessed: access to peritoneal cavity (easy, difficult), bleeding during surgery (normal, abnormal), gall bladder bed dissection (easy, difficult), injury to duct/artery, and conversion to open surgery. In the present study, BMI > 30, history of cholecystitis, gall bladder wall thickness > 4mm, palpable gall bladder, pericholecystic fluid collection, impacted stone were significant predictive factors for difficult laparoscopic cholecystectomy .

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[Dhea M. Sh. Ahmad. (2017); SCORING SYSTEM FOR PREDICTING RISK FACTORS FOR DIFFICULT LAPAROSCOPIC CHOLECYSTECTOMY. Int. J. of Adv. Res. 5 (Jul). 148-155] (ISSN 2320-5407). www.journalijar.com

Dr. Dhea M. Sh. Ahmad, C.A.B.S
Al-Fallouja Teaching Hospital, Al-Fallouja, Iraq

DOI:

Article DOI: 10.21474/IJAR01/4704      
DOI URL: http://dx.doi.org/10.21474/IJAR01/4704

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