World Journal of Laparoscopic Surgery

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VOLUME 15 , ISSUE 3 ( September-December, 2022 ) > List of Articles

Original Article

Role of Preoperative Ultrasonography Findings in Predicting Difficult Laparoscopic Cholecystectomy

Sathishkumar Arone, Raghunath KJ, R Venkatasubramanian, M Muralidharan, Dakshay Chordia

Keywords : Difficult laparoscopy, Gallbladder, Laparoscopic cholecystectomy, Prospective observational study, Ultrasonography

Citation Information : Arone S, KJ R, Venkatasubramanian R, Muralidharan M, Chordia D. Role of Preoperative Ultrasonography Findings in Predicting Difficult Laparoscopic Cholecystectomy. World J Lap Surg 2022; 15 (3):229-234.

DOI: 10.5005/jp-journals-10033-1539

License: CC BY-NC 4.0

Published Online: 08-12-2022

Copyright Statement:  Copyright © 2022; Jaypee Brothers Medical Publishers (P) Ltd.


Aim: Most of the complications in a laparoscopic cholecystectomy are due to the difficulties faced during the surgery. In this research, the attempt was made to determine the factors that can predict a difficult laparoscopic cholecystectomy preoperatively based on ultrasound findings. Materials and methods: One hundred patients who are satisfied with our inclusion criteria were included in our study. Preoperative ultrasonography (USG) findings like thickness and size of the gallbladder (GB) wall, the diameter of the common bile duct (CBD), GB stone size and numbers, and the existence of fluid collection around the GB were given a grade of 1 or 0 based on findings being affirmative or dissent. The sums of the grade were taken and were interrelated with the difficult laparoscopic cholecystectomy. Intraoperative findings, namely, injury and damages made to the bile duct, CBD or artery, the existence of thick adhesions on the GB sides, region of the Calot's being frozen, ripped up GB and spillage of bile and stones, unusual and atypical anatomy, bleeding that hampers and obstructs the visual field, and time taken of 60–120 minutes were considered as difficult laparoscopic cholecystectomy. Results: Four preoperative findings, namely, the thickness of GB, GB stone impacted at the neck, GB stone size, and the existence of fluid collection around the GB had statistical significance in anticipating a difficult laparoscopic cholecystectomy. An elevated preoperative ultrasonography score had shown higher chances of a difficult laparoscopic cholecystectomy. Conclusion: Preoperative ultrasonography findings have a role in predicting a difficult laparoscopic cholecystectomy. Clinical significance: Laparoscopic cholecystectomy will be useful to have some authentic factors (USG findings) to prognosticate difficulty, conversion, or complications in laparoscopic cholecystectomy.

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