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Research Paper | General Surgery | India | Volume 12 Issue 4, April 2023 | Popularity: 5.2 / 10

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Pre-Operative Prediction of Difficulty Grading in Laparoscopic Cholecystectomy using Scoring Method - A Cross-Sectional Descriptive Study

Dr. N. Subaashini, Dr. Deepu Thiyagarajan, Dr. S. P. Venkatesh

Abstract: Introduction: Any age group might be impacted by gallstones. The likelihood of gall stone disease increases with age. The aim of the study was to evaluate a scoring method to predict difficult Laparoscopic Cholecystectomy preoperatively. Materials and Methods: It is a Cross sectional descriptive study conducted at Department of General Surgery, Sri Venkateshwaraa Medical College Hospital and Research Centre for 18 months (March 2021 - July 2022). All patients undergoing laparoscopic cholecystectomy for gall stone disease were included. Laparoscopy to open conversion due to intraoperative suspicion of malignancy, laparoscopy to open conversion due to Gallbladder perforation diagnosed intraoperatively and laparoscopy to open conversion for CBD stone were excluded. Scoring method used were Randhawa and Pujahari scoring system. Estimated sample size was around 76 using Sensitivity-80% (Parent article -Preoperative prediction of difficult laparoscopic cholecystectomy: A SCORING METHOD [JUNE 2016]); confidence Interval-95%, margin of error-9% and sample size calculated using EPI INFO version 7.3.1.2 Results: In present study about 55% were of age 41 to 50 years. About 23.7% were in the age of 51 to 60 years. About 10.7% were in the age of 61 to 70 years. Only 5.3% were in the age of less than 40 years of age. Mean age is 42.17 and SD is 11.41. In present study about 30% were male, 70% were females. In present study about 46% were overweight, 46% were obese. Mean BMI is 25.37 and SD is 5.68. About 37% were smokers and 29% were alcoholics. The sensitivity was 83.33%, specificity 95%, positive predictive value 93.75% and negative predictive value 86.36%. Conclusion: A preoperative scoring system based on age, gender, history, clinical examination, laboratory, sonographic findings was created to help surgeons decide on a surgical approach, counsel the patients, reduce the risk of complication, reduce the rate of conversion to open cholecystectomy, reduce overall medical cost.

Keywords: Laparoscopic cholecystectomy, grading, scoring, difficult, gallstones

Edition: Volume 12 Issue 4, April 2023

Pages: 1369 - 1373

DOI: https://www.doi.org/10.21275/SR23416215025

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