Diagnostic power of the proposed scoring system for predicting laparoscopic cholecystectomy hardness

Background and Aim: Recognition of factors is necessary to predict the severity of cholecystectomy. The aim of this study was to evaluate the diagnostic power of the proposed scoring system for predicting the severity of laparoscopic cholecystectomy.Materials and Methods: In this cross-sectional study, there were ۱۲۲ patients who underwent cholecystectomy in Shahid Beheshti Hospital during ۱۳۹۷. Prior to surgery, accurate history, clinical, laboratory, and ultrasound information were recorded and scored on a checklist. Finally, the difficulty ofcholecystectomy was three degrees of ease (less than ۶۰ minutes, uncomplicated) and difficult (between ۶۰ and ۹۰ minutes). Divided into controllable) and very difficult (between ۹۰ and ۱۲۰ minutes with uncontrollable complications or open surgery). Data were analyzed in SPSS software version ۲۲ and theindicators were calculated for the purpose of the study. Results: ۲۸ (۲۲.۴%) were male and ۹۷ (۷۷.۶%) were female in this study. The mean age of patients in easy operations was ۴۴.۷۱. ۱۳.۵۶ years and in difficult operations was ۴۴.۵۲. ۱۴.۵۶ years. There was no statistically significant relationship between age (P value; ۰.۹۳۹), patients' gender and history of acute cholecystitis attacks with the difficulty of laparoscopic cholecystectomy (P value ≥ ۰.۰۵). But between the palpable gallbladder (P value: ۰۰۰). Impacted stone (P value: ۰۰۰). Gallbladder wall thickness (P value: ۰۰۰), BMI above ۳۰ (P value: ۰۰۰) and there was a statistically significant relationship between the difficulty of operation. There was also a significant relationship between AST (P value: ۰۳۴), T Bill (P value: ۰۰۸) WBC (P value: ۰۰۰), and thedifficulty of laparoscopic cholecystectomy, but between ALT (P value: ۰۶۵), The severity of cholecystectomy was not significantly related. Sensitivity (۸۶%), specificity (۵۸%), positive predictive value (۴۴%) andnegative predictive value (۹۱%) were calculated for the scoring system for the difficulty of laparoscopic cholecystectomy.Conclusion: To predict the difficulty of laparoscopic cholecystectomy, we strongly recommend the preoperative scoring system. It is also recommended to conduct further studies on the use of the scoring system during surgery.

Keywords:

Laparoscopic cholecystectomy , scoring system , preoperative findings , intraoperative findings