ArticleAnnals of medicine and surgery (2012)2018
A new clinical-ultrasound score to predict difficult videolaparocholecystectomies: A prospective study.
Article in Annals of medicine and surgery (2012), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Reporting and data systems for laparoscopic cholecystectomy with findings of a user adoption survey.Scientific reports · 2026Article
- Performance of ultrasound in the diagnosis of cholecystitis: not so (ultra)sound?Annals of the Royal College of Surgeons of England · 2022Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe gold standard treatment of symptomatic cholelithiasis is videolaparoscopic cholecystectomy (VLC). The aim of this study is to produce a predictive clinical ultrasound (US) score for difficult VLC to reduce the rate of conversion to open cholecystectomy surgery and intra and/or post-operative complications.
methodsIn this prospective study carried out in 2017 we enrolled 135 patients (pts) who underwent VLC in our General Surgery Unit. A specific pre-operative abdominal ultrasound scan was performed to assess gallbladder characteristics for each patient. All US and patients' characteristics were recorded in a standard form in order to obtain a preoperative score and were then added to the intra-operative variables.
resultsThe analysis revealed a statistical significance between post-operative characteristics and parietal thickness, adhesions, stratifications and volume of gallstones. Comparing the degree of difficulty VLC assessed in the pre-operative stage to the intraoperative score, the sensitivity of the preoperative US scan test is 91.8% while the specificity is 76.7%.
conclusionsThe variables which proved statistically significant in predicting a difficult cholecystectomy were: age, parietal thickness >3 mm, adhesions, stratifications, gallstones >2 cm and fixed gallstones. We have definitively defined a predictive score for difficult VLC for which a VLC is to be considered potentially difficult whenever it presents a pre-operative score equal or greater than 4 (and a "easy" one with a pre-operative score less than 4). These findings may prove helpful in further reducing the conversion rate and the rate of intra- and/or post-operative complications.
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