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. 2009 Aug;71(4):198-201.
doi: 10.1007/s12262-009-0055-y. Epub 2009 Sep 2.

Preoperative prediction of difficult lap chole: a scoring method

Jaskiran S Randhawa  1 , Aswini K Pujahari
Affiliations

Preoperative prediction of difficult lap chole: a scoring method

Jaskiran S Randhawa et al. Indian J Surg. 2009 Aug.

Abstract

Background: Laparoscopic cholecystectomy (LC) has become the procedure of choice for management of symptomatic gallstone disease. At times it is easy and can be done quickly. Occasionally it is difficult and takes longer time. But there is no scoring system available to predict the degree of difficulty of LC preoperatively.

Aim: To develop a scoring method to predict difficult LC preoperatively.

Materials and methods: There were 228 cases in 2 years, operated by a single experienced surgeon. There are total 15 score from history, clinical, sonological findings. Score up to 5 predicted easy, 6-10 difficult and >10 are very difficult.

Results: Prediction came true in 88.8% for easy and 92% difficult cases there were no cases with score above 10. The factors like BMI > 27.5 (p < 0.010), previous hospitalization (p < 0.001), palpable GB (p < 0.01) US-Thick-walled GB (p < 0.038) are found of statistical significance in predicting difficult LC.

Conclusion: The proposed scoring system is reliable with a sensitivity and specificity of 75.00% and 90.24%, respectively.

Keywords: Difficult; Lap chole; Prediction; Scoring.

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References

    1. Lam C.M., Murray F.E., Cuschieri A. Increased cholecystectomy rate after the introduction of laparoscopic cholecystectomy in Scotland. Gut. 1996;38:282–284. doi: 10.1136/gut.38.2.282. - DOI - PMC - PubMed
    1. The southern Surgeons Club. Meyers W.C. A prospective analysis of 1518 laparoscopic cholecystectomy. N Engl J Med. 1991;324:1073–1078. - PubMed
    1. Kama N.A., Kolongue M., Doganay M., Reis E., Atle M., Dolapiu M. Risk score conversion from laparoscopic to open cholecystectomy. Am J Surg. 2001;181:520–525. doi: 10.1016/S0002-9610(01)00633-X. - DOI - PubMed
    1. Kanaan S.A., Murayama K.M., Merriam L.T., Dawes L.G., Puystowsky J.B., Reye R.B., Jochl R.J. Risk factor for conversion of laparoscopic to open cholecystectomy. J Surg Res. 2002;106:20–24. doi: 10.1006/jsre.2002.6393. - DOI - PubMed
    1. Heng-Hui Lein M.D., Ching-Shui H. Male gender: Risk factor for severe symptomatic cholelithiasis. World J Surg. 2002;26:598–601. doi: 10.1007/s00268-001-0275-1. - DOI - PubMed

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