| Peer-Reviewed

Grading System Based on Intra Operative Findings at Laparoscopic Cholecystectomy

Received: 15 August 2018     Accepted: 1 September 2018     Published: 19 September 2018
Views:       Downloads:
Abstract

Laparoscopic Cholecystectomy has become the standard of care for Gall Stone Disease. There are numerous studies and scoring system which considers the pre-operative factors for conversion to open cholecystectomy but there was no scoring system which considers intra operative findings. The objective of this study was to outline the scoring system based on intra operative findings to predict the conversion of laparoscopic cholecystectomy to open cholecystectomy. This prospective study was carried out on 158 patients who underwent cholecystectomy. Surgery in all patients were started with laparoscopic cholecystectomy and based on multiple factors the surgery was completed as open or laparoscopic cholecystectomy. Based on the intra operative findings the patients were divided into easy, moderate, very difficult and extreme. The patients with severe and extreme scoring had highest number of conversions to open cholecystectomy and those patients who had total score of less than 5 had negligible conversion to open cholecystectomy. This paper reports the scoring system which considers the intra operative findings during laparoscopic cholecystectomy. Based on this scoring system it can be predicted weather conversion to open cholecystectomy is required or not.

Published in Journal of Surgery (Volume 6, Issue 5)
DOI 10.11648/j.js.20180605.13
Page(s) 123-128
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2018. Published by Science Publishing Group

Keywords

Laparoscopic Cholecystectomy, Open Cholecystectomy, Grading System, Intra Operative Findings, Pre-Operative Findings

References
[1] McKernan JB, Champion JK. Access techniques: Veress needle— initial blind trocar insertion versus open laparoscopy with the Hasson trocar. Endosc. Surg. Allied Technol. 1995; 3:35.
[2] Ballem RV, Rudomanski J. Techniques of pneumoperitoneum. Surg. Laparosc. Endosc. 1993; 3:42.
[3] Alexander JI. Pain after laparoscopy. Br. J. Anaesth. 1997; 79:369.
[4] Rademaker BM, Kalkman CJ, Odoom JA, et al. Intraperitoneal local anaesthetics after laparoscopic cholecystectomy: effects on postoperative pain, metabolic responses and lungfunction.Br.J.Anaesth.1994; 72:263.
[5] LeeIO, KimSH, KongMH, etal. Pain after laparoscopic cholecystectomy: the effect and timing of incisional and intraperitoneal bupivacaine. Can. J. Anaesth. 2001; 48:545.
[6] Murphy JB. The diagnosis of gall stones. Am Med News 1903:825-833.
[7] Hanif G Motiwala: Operative Technique Cholecystectomy A study of 250 Cases: SURGERY IN THE Tropics Ed: Sakens: Jhawes PK: Purohit A Mc Milan India Ltd1991, 56, 204.
[8] Jaskiran S. Randhawa, Aswini K. Pujahari: Preoperative prediction of difficult lap chole: a scoring method, Indian J Surg (July- august 2009) 71:198-201.
[9] Alexander P Nagle, Nathaniel J, Soper James R Hines; Cholecystectomy (open and laparoscopic).Michael J Zinner Stanley W Ashley; Maingot’s Abdominal.
[10] Strasburg S M, Hertl M, Soper N S. An analysis of the problem of biliary injury during laparoscopic cholecystectomy. J Ann Coll Surg 1995; 180: 101-125.
[11] Birkett D HRonsky J LStiegmann G V. The SAGES manual- Fundamentals of Laparoscopic and GI Endoscopy. Springer2003: 137- 142.
[12] Gupta N, Ranjan G, Arora MP, Binita Goswami, Poras Choudhary, Arun Kapur, et al: Validation of a scoring system to predict difficult laparoscopic cholecystectomy. International Journal of Surgery 2013;11: 1002-1006.
[13] Kama N A, Dogary M, Dolapa M. Reise, Attli M, et al! Risk factors resulting in conversion of laparoscopic cholecystectomy to open cholecystectomy. Surgical endoscopy, Springer New York: V5 965-968.
[14] Daradkeh S laparoscopic cholecystectomy: What are the factors determining difficulty? Hepatogastroenterology. 2001 Jan, Feb; 48(37): 76-78.
[15] Jorgensen J O, Hunt D R: laparoscopic cholecystectomy. A prospective analysis of the potential causes of failure. Surg laparos endosc 3: 49- 531993.
[16] Fried GM, Barkun JS, Sigman HH, Joseph L, Uas D, Garzon J, Hinchey EJ, Meakins JL (1994) Factors determining conversion to laparotomy in patients undergoing laparoscopic cholecystectomy.
[17] Ahmet Alponat, Cheng K, Bee C Koh, Andrea R, Peter MY Goh (1997): Predictive factors for conversion of laparoscopic cholecystectomy. World J Surg 21:629-633. 37.
[18] Kanaan SA, Murayama KM, Merriam LT, Dawes LG, Puystowsky JB, Reye RB, Jochi RJ (2002) Risk factors for conversion of laparoscopic to open cholecystectomy. J Surg Res 106:20-24.
[19] Vivek MA, Augustine AJ, Rao R: A comprehensive predictive scoring method for difficult laparoscopic cholecystectomy. Journal of minimal access surgery. 2014; 10:62-7.
[20] Michael Sugrue, Shaheel M, Sahebally Luca, Ansaloni, martin, D Zielinski: Grading operative findings at laparoscopic cholecystectomy- a new scoring system. World Journal of Emergency Surgery. 2015; 10:14.
[21] Takada T, Strasberg SM, Solomkin JS , Pitt HA, Gomi H, Yoshida M, et al. TG 13 Updated Tokyo guidelines for the management of acute cholangitis and cholecytitis. J Hepatobliary Pacreat Sci. 2013; 20:1-7.
[22] Stromberg C , Nilsson M. Nationwide study of the treatment of common bile duct stones in Sweden between 1965 and 2009. Br J Sirg.2014;98:1766-74.
[23] De Mestral C, Rostein OD, Lapacis A, Hoch JS, Zagorski, Alali A S, et al. Comparative operative outcomes of early and delayed cholecystectomy for acute cholecystitis: a population based propensity score analysis. Ann Surg. 2014; 259:10-5.
[24] Singh Kohri A. Difficult laparoscopic cholecystectomy: a large series from North India. Ind J Surg. 2006; 68:205e208.
[25] Nachnani J Supe A. Pre- operative prediction of difficult laparoscopic cholecystectomy using clinical and ultrasonographic parameters. Indian journal of gastroenterology. 2005; 24:8-16.
Cite This Article
  • APA Style

    Brajesh Kumar, Saurov Ghose, Vipul Krishan Sharma, Manashi Ghosh. (2018). Grading System Based on Intra Operative Findings at Laparoscopic Cholecystectomy. Journal of Surgery, 6(5), 123-128. https://doi.org/10.11648/j.js.20180605.13

    Copy | Download

    ACS Style

    Brajesh Kumar; Saurov Ghose; Vipul Krishan Sharma; Manashi Ghosh. Grading System Based on Intra Operative Findings at Laparoscopic Cholecystectomy. J. Surg. 2018, 6(5), 123-128. doi: 10.11648/j.js.20180605.13

    Copy | Download

    AMA Style

    Brajesh Kumar, Saurov Ghose, Vipul Krishan Sharma, Manashi Ghosh. Grading System Based on Intra Operative Findings at Laparoscopic Cholecystectomy. J Surg. 2018;6(5):123-128. doi: 10.11648/j.js.20180605.13

    Copy | Download

  • @article{10.11648/j.js.20180605.13,
      author = {Brajesh Kumar and Saurov Ghose and Vipul Krishan Sharma and Manashi Ghosh},
      title = {Grading System Based on Intra Operative Findings at Laparoscopic Cholecystectomy},
      journal = {Journal of Surgery},
      volume = {6},
      number = {5},
      pages = {123-128},
      doi = {10.11648/j.js.20180605.13},
      url = {https://doi.org/10.11648/j.js.20180605.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20180605.13},
      abstract = {Laparoscopic Cholecystectomy has become the standard of care for Gall Stone Disease. There are numerous studies and scoring system which considers the pre-operative factors for conversion to open cholecystectomy but there was no scoring system which considers intra operative findings. The objective of this study was to outline the scoring system based on intra operative findings to predict the conversion of laparoscopic cholecystectomy to open cholecystectomy. This prospective study was carried out on 158 patients who underwent cholecystectomy. Surgery in all patients were started with laparoscopic cholecystectomy and based on multiple factors the surgery was completed as open or laparoscopic cholecystectomy. Based on the intra operative findings the patients were divided into easy, moderate, very difficult and extreme. The patients with severe and extreme scoring had highest number of conversions to open cholecystectomy and those patients who had total score of less than 5 had negligible conversion to open cholecystectomy. This paper reports the scoring system which considers the intra operative findings during laparoscopic cholecystectomy. Based on this scoring system it can be predicted weather conversion to open cholecystectomy is required or not.},
     year = {2018}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Grading System Based on Intra Operative Findings at Laparoscopic Cholecystectomy
    AU  - Brajesh Kumar
    AU  - Saurov Ghose
    AU  - Vipul Krishan Sharma
    AU  - Manashi Ghosh
    Y1  - 2018/09/19
    PY  - 2018
    N1  - https://doi.org/10.11648/j.js.20180605.13
    DO  - 10.11648/j.js.20180605.13
    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
    SP  - 123
    EP  - 128
    PB  - Science Publishing Group
    SN  - 2330-0930
    UR  - https://doi.org/10.11648/j.js.20180605.13
    AB  - Laparoscopic Cholecystectomy has become the standard of care for Gall Stone Disease. There are numerous studies and scoring system which considers the pre-operative factors for conversion to open cholecystectomy but there was no scoring system which considers intra operative findings. The objective of this study was to outline the scoring system based on intra operative findings to predict the conversion of laparoscopic cholecystectomy to open cholecystectomy. This prospective study was carried out on 158 patients who underwent cholecystectomy. Surgery in all patients were started with laparoscopic cholecystectomy and based on multiple factors the surgery was completed as open or laparoscopic cholecystectomy. Based on the intra operative findings the patients were divided into easy, moderate, very difficult and extreme. The patients with severe and extreme scoring had highest number of conversions to open cholecystectomy and those patients who had total score of less than 5 had negligible conversion to open cholecystectomy. This paper reports the scoring system which considers the intra operative findings during laparoscopic cholecystectomy. Based on this scoring system it can be predicted weather conversion to open cholecystectomy is required or not.
    VL  - 6
    IS  - 5
    ER  - 

    Copy | Download

Author Information
  • Department of Surgery, Military Hospital, Dehradun, India

  • Department of Surgery, Military Hospital, Dehradun, India

  • Department of Anesthesia, Military Hospital, Dehradun, India

  • Department of Radiotherapy, Govt Doon Medical College, Dehradun, India

  • Sections