Abstract:
Objective: To determine the accuracy of ultrasound in predicting difficult laparoscopic cholecystectomy, keeping preoperative findings as gold standard. Methodology: A cross sectional study was conducted from July 2018 to January 2019 at Department of General Surgery, Pakistan Institute of Medical Sciences Islamabad. Adult patients with diagnosis of cholelithiasis were included in the study by consecutive sampling, who underwent laparoscopic cholecystectomy. Preoperative ultrasound parameters such as gallbladder wall thickness, size & number of gallstones, pericholecystic fluid, impacted stone and contracted gall bladder were studied. Intraoperative difficulty of laparoscopic cholecystectomy was determined by the criteria as procedure time more than 60 minutes, dissection at Calot's triangle more than 30 minutes and tear of gallbladder. Results: A total of 150 patients were included in the study with mean age of 41.4+9.9 years. There were 29(19.3%) males and 121(80.7%) females with male to female ratio of 1:4. Preoperative ultrasonography (USG) findings such as gall bladder wall thickness >4mm, size of the stone =1 cm impacted gall stones, contracted gall bladder and presence of pericholecystic fluid were significantly (p value= 0.001) associated with difficult laparoscopic cholecystectomy. Conclusion: In majority of the patients, preoperative ultrasonography is found as a good predictor of difficult laparoscopic cholecystectomy and should be used as a screening procedure.
Page(s):
1-5
DOI:
DOI not available
Published:
Journal: Journal of Aziz Fatimah Medical and Dental College, Volume: 4, Issue: 1, Year: 2022