Predictive risk factor for difficult elective laparoscopic cholecystectomy in HUSM

Background : Laparoscopic cholecystectomy (LC) is a gold standard management for symptomatic cholelithiasis. However, LC might be difficult due to the various risk factors. Preoperative risk factors are very important for the surgeon and patient in anticipating of difficulty during surgery. The a...

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Main Author:	Azmi, Mohd Azem Fathi Mohammad
Format:	Thesis
Language:	English
Published:	2021
Subjects:	RG Gynecology and obstetrics
Online Access:	http://eprints.usm.my/58913/1/MOHD%20AZEM%20FATHI%20B%20MOHAMMAD%20AZMI-24%20pages.pdf
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spelling	my-usm-ep.589132023-08-06T07:43:59Z Predictive risk factor for difficult elective laparoscopic cholecystectomy in HUSM 2021 Azmi, Mohd Azem Fathi Mohammad RG Gynecology and obstetrics Background : Laparoscopic cholecystectomy (LC) is a gold standard management for symptomatic cholelithiasis. However, LC might be difficult due to the various risk factors. Preoperative risk factors are very important for the surgeon and patient in anticipating of difficulty during surgery. The aim of this study to identify clinical, radiological, and perioperative risk factor with difficult elective laparoscopic cholecystectomy patient in HUSM. Methods: This is a retrospective record review of patients who underwent elective laparoscopic cholecystectomy from 2013 to 2018 in Hospital Universiti Sains Malaysia. The patient’s characteristics, clinical history, laboratory data, ultrasonography results and intraoperative details were retrospectively analyzed to evaluate predictors of difficult LC. Results: A total of 154 patients whom underwent elective laparoscopic cholecystectomy and fullfill the criteria were included in this study. The conversion rate to open surgey was 4.5%, the mean operative length was 91.71 minutes and the mean hospital stay post operative was one day. The prevalence of difficult elective laparoscopic cholecystectomy in HUSM was 55.2% (95% CI = 47.3, 63.0). Multivariate analysis showed that history of cholangitis , history of ERCP , thick gallbladder wall on ultrasound , dense adhesion and fibrosed Calot’s triangle intraoperatively had significant association with difficult laparoscopic cholecystectomy. Conclusion: From this study, it is concluded that patient’s history of cholangitis, history of ERCP, thick gallbladder wall on ultrasound, dense adhesion and fibrosed Calot’s triangle intraoperatively were found to be the predictive factors of difficult LC. 2021 Thesis http://eprints.usm.my/58913/ http://eprints.usm.my/58913/1/MOHD%20AZEM%20FATHI%20B%20MOHAMMAD%20AZMI-24%20pages.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution	Universiti Sains Malaysia
collection	USM Institutional Repository
language	English
topic	RG Gynecology and obstetrics
spellingShingle	RG Gynecology and obstetrics Azmi, Mohd Azem Fathi Mohammad Predictive risk factor for difficult elective laparoscopic cholecystectomy in HUSM
description	Background : Laparoscopic cholecystectomy (LC) is a gold standard management for symptomatic cholelithiasis. However, LC might be difficult due to the various risk factors. Preoperative risk factors are very important for the surgeon and patient in anticipating of difficulty during surgery. The aim of this study to identify clinical, radiological, and perioperative risk factor with difficult elective laparoscopic cholecystectomy patient in HUSM. Methods: This is a retrospective record review of patients who underwent elective laparoscopic cholecystectomy from 2013 to 2018 in Hospital Universiti Sains Malaysia. The patient’s characteristics, clinical history, laboratory data, ultrasonography results and intraoperative details were retrospectively analyzed to evaluate predictors of difficult LC. Results: A total of 154 patients whom underwent elective laparoscopic cholecystectomy and fullfill the criteria were included in this study. The conversion rate to open surgey was 4.5%, the mean operative length was 91.71 minutes and the mean hospital stay post operative was one day. The prevalence of difficult elective laparoscopic cholecystectomy in HUSM was 55.2% (95% CI = 47.3, 63.0). Multivariate analysis showed that history of cholangitis , history of ERCP , thick gallbladder wall on ultrasound , dense adhesion and fibrosed Calot’s triangle intraoperatively had significant association with difficult laparoscopic cholecystectomy. Conclusion: From this study, it is concluded that patient’s history of cholangitis, history of ERCP, thick gallbladder wall on ultrasound, dense adhesion and fibrosed Calot’s triangle intraoperatively were found to be the predictive factors of difficult LC.
format	Thesis
qualification_level	Master's degree
author	Azmi, Mohd Azem Fathi Mohammad
author_facet	Azmi, Mohd Azem Fathi Mohammad
author_sort	Azmi, Mohd Azem Fathi Mohammad
title	Predictive risk factor for difficult elective laparoscopic cholecystectomy in HUSM
title_short	Predictive risk factor for difficult elective laparoscopic cholecystectomy in HUSM
title_full	Predictive risk factor for difficult elective laparoscopic cholecystectomy in HUSM
title_fullStr	Predictive risk factor for difficult elective laparoscopic cholecystectomy in HUSM
title_full_unstemmed	Predictive risk factor for difficult elective laparoscopic cholecystectomy in HUSM
title_sort	predictive risk factor for difficult elective laparoscopic cholecystectomy in husm
granting_institution	Universiti Sains Malaysia
granting_department	Pusat Pengajian Sains Perubatan
publishDate	2021
url	http://eprints.usm.my/58913/1/MOHD%20AZEM%20FATHI%20B%20MOHAMMAD%20AZMI-24%20pages.pdf
_version_	1776101242671464448

Predictive risk factor for difficult elective laparoscopic cholecystectomy in HUSM

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