Abstract

BackgroundLaparoscopic surgery for gallbladder cholecystectomy has become the typical procedure for symptomatic gallbladder stone diseases treatment as a type of minimal invasiveness surgery associated with less pain and early recovery as there is minimal trauma of access without shrinking the exposure of operative field. The current study aimed to assess factors associated with difficult LC.MethodologyA cross sectional study was conducted at medical city complex (Baghdad Teaching Hospital) from October 2015 to October 2016, in which all patients that were admitted for LC were examined preoperatively, underwent LC and followed postoperatively to study factors associated with difficult LC. All LC were operated by qualified senior surgeons and supervised by well-trained resident doctors. A pre-operative score system parameters were obtained from history, clinical examination and investigation findings.ResultsLaparoscopic cholecystectomy was performed for 100 patients, 78% were females and 49% were among 40–59 years of age. The preoperative scoring revealed that in 58% of the patients the score indicate difficulty, and very difficult in only 7% of the patients. Difficult and very difficult operations were significantly associated with high difficult scoring preoperatively, gender, BMI and cause of admission.ConclusionHigh difficult scoring preoperatively, gender, BMI and cause of admission can be used as predictors for difficult LC.

Highlights

  • Cholecystectomy by Laparoscopic surgery affords an effective and safe model treatment for many patients with symptomatic gallbladder stone diseases [1] and is the golden treatment of choice for cholelithiasis

  • Laparoscopic cholecystectomy has become the typical surgery for treatment of symptomatic cholelithiasis as a type of minimal invasiveness surgery associated with less pain and early recovery as there is minimal trauma of access without shrinking the exposure of operative field, it has the advantage of better exposure and a better view [5]

  • On day of admission before operation, each patient was scored according to the eleven parameters which were by history, Age, Sex, previous admission to hospital for acute cholecystitis or biliary colic and by clinical examination including Body mass index (BMI), Abdominal scar, Palpable gallbladder and radiological findings “Wall thickness, Pericholecystic collection, Impacted stone”

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Summary

Introduction

Cholecystectomy by Laparoscopic surgery affords an effective and safe model treatment for many patients with symptomatic gallbladder stone diseases [1] and is the golden treatment of choice for cholelithiasis. It has become the most common operation performed in United States has increased from 5 to 7 lakhs/year [2]. Laparoscopic surgery for gallbladder cholecystectomy has become the typical procedure for symptomatic gallbladder stone diseases treatment as a type of minimal invasiveness surgery associated with less pain and early recovery as there is minimal trauma of access without shrinking the exposure of operative field. Conclusion: High difficult scoring preoperatively, gender, BMI and cause of admission can be used as predictors for difficult LC

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