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Grading operative findings at laparoscopic cholecystectomy following the new scoring system in Duhok governorate: Cross sectional study

INTRODUCTION: Numerous preoperative scoring systems predict difficult laparoscopic cholecystectomy. Recently, the intraoperative difficulties which are facing surgeons are studied. A new scoring system categorize patients according to many intraoperative findings with a final outcome whether convert...

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Autores principales: Jameel, Sanar Majeed, Bahaddin, Muwafaq Masoud, Mohammed, Ayad Ahmad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7649370/
https://www.ncbi.nlm.nih.gov/pubmed/33204417
http://dx.doi.org/10.1016/j.amsu.2020.10.035
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author Jameel, Sanar Majeed
Bahaddin, Muwafaq Masoud
Mohammed, Ayad Ahmad
author_facet Jameel, Sanar Majeed
Bahaddin, Muwafaq Masoud
Mohammed, Ayad Ahmad
author_sort Jameel, Sanar Majeed
collection PubMed
description INTRODUCTION: Numerous preoperative scoring systems predict difficult laparoscopic cholecystectomy. Recently, the intraoperative difficulties which are facing surgeons are studied. A new scoring system categorize patients according to many intraoperative findings with a final outcome whether converting to open cholecystectomy or continuing laparoscopically. PATIENTS AND METHODS: This prospective study included 120 patients admitted for laparoscopic cholecystectomy for symptomatic gallstones from October 2019 to August 2020. Intraoperative difficulties were evaluated and patients were categorized according to intraoperative scoring for cholecystitis severity and compared depending to the rate of conversion to the open technique. RESULTS: Most patient were middle aged females having multiple gallstones, the mean operation time was 35 min and 7.8% of patients were converted to open cholecystectomy because of intraoperative difficulty. There was a significant correlation between the conversion rate and each of distended and/or contracted gall bladder, inability to grasp the gall bladder with traumatic forceps, stone ≥1 cm impacted in Hartman's pouch, and bile or pus outside gallbladder (P values: 0.002, 0.000, 0.008 and 0.015) respectively, and no significant correlation with gallbladder adhesions, adhesions from previous upper abdominal surgery, BMI>30, and Time to identify cystic artery and duct >90 min (P values: 0.123, 1, 1, 0.078) respectively. CONCLUSION: New intraoperative scoring systems are valuable in predicting difficulties and preventing increase operation time and possible injuries. The main points of difficulties are distended or contracted gallbladder, large stone impaction, difficult grasping the wall of the gall bladder and the presence of bile or pus outside the gall bladder.
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spelling pubmed-76493702020-11-16 Grading operative findings at laparoscopic cholecystectomy following the new scoring system in Duhok governorate: Cross sectional study Jameel, Sanar Majeed Bahaddin, Muwafaq Masoud Mohammed, Ayad Ahmad Ann Med Surg (Lond) Cross-sectional Study INTRODUCTION: Numerous preoperative scoring systems predict difficult laparoscopic cholecystectomy. Recently, the intraoperative difficulties which are facing surgeons are studied. A new scoring system categorize patients according to many intraoperative findings with a final outcome whether converting to open cholecystectomy or continuing laparoscopically. PATIENTS AND METHODS: This prospective study included 120 patients admitted for laparoscopic cholecystectomy for symptomatic gallstones from October 2019 to August 2020. Intraoperative difficulties were evaluated and patients were categorized according to intraoperative scoring for cholecystitis severity and compared depending to the rate of conversion to the open technique. RESULTS: Most patient were middle aged females having multiple gallstones, the mean operation time was 35 min and 7.8% of patients were converted to open cholecystectomy because of intraoperative difficulty. There was a significant correlation between the conversion rate and each of distended and/or contracted gall bladder, inability to grasp the gall bladder with traumatic forceps, stone ≥1 cm impacted in Hartman's pouch, and bile or pus outside gallbladder (P values: 0.002, 0.000, 0.008 and 0.015) respectively, and no significant correlation with gallbladder adhesions, adhesions from previous upper abdominal surgery, BMI>30, and Time to identify cystic artery and duct >90 min (P values: 0.123, 1, 1, 0.078) respectively. CONCLUSION: New intraoperative scoring systems are valuable in predicting difficulties and preventing increase operation time and possible injuries. The main points of difficulties are distended or contracted gallbladder, large stone impaction, difficult grasping the wall of the gall bladder and the presence of bile or pus outside the gall bladder. Elsevier 2020-10-23 /pmc/articles/PMC7649370/ /pubmed/33204417 http://dx.doi.org/10.1016/j.amsu.2020.10.035 Text en © 2020 The Authors http://creativecommons.org/licenses/by/4.0/ This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Cross-sectional Study
Jameel, Sanar Majeed
Bahaddin, Muwafaq Masoud
Mohammed, Ayad Ahmad
Grading operative findings at laparoscopic cholecystectomy following the new scoring system in Duhok governorate: Cross sectional study
title Grading operative findings at laparoscopic cholecystectomy following the new scoring system in Duhok governorate: Cross sectional study
title_full Grading operative findings at laparoscopic cholecystectomy following the new scoring system in Duhok governorate: Cross sectional study
title_fullStr Grading operative findings at laparoscopic cholecystectomy following the new scoring system in Duhok governorate: Cross sectional study
title_full_unstemmed Grading operative findings at laparoscopic cholecystectomy following the new scoring system in Duhok governorate: Cross sectional study
title_short Grading operative findings at laparoscopic cholecystectomy following the new scoring system in Duhok governorate: Cross sectional study
title_sort grading operative findings at laparoscopic cholecystectomy following the new scoring system in duhok governorate: cross sectional study
topic Cross-sectional Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7649370/
https://www.ncbi.nlm.nih.gov/pubmed/33204417
http://dx.doi.org/10.1016/j.amsu.2020.10.035
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