A study on ultrasound scoring predicting the conversion of laparoscopic to open cholecystectomy

Jegadhes Kumar, D (2016) A study on ultrasound scoring predicting the conversion of laparoscopic to open cholecystectomy. Masters thesis, Madras Medical College, Chennai.

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Abstract

BACK GROUND AND OBJECTIVES: The aim of this study is to preoperatively predict the conversion of Laparoscopic to open cholecystectomy by using ultrasound scoring the following factors GB status, GB wall thickness, number of stones , pericholecystic collection , stone size METHODOLOGY: A total of 50 cases with gall stones admitted in RGGGH, madras medical college during the period of January 2015 to September 2015 and planned for laparoscopic cholecystectomy were analysed in this study , they are subjected to detailed history, clinical examination , name , age , sex and findings of USG abdomen were recorded , All these patients were subjected to laparoscopic cholecystectomy. RESULT: Out of 50 patients, GB status - 35 patients GB status was normal, of the remaining 15 patients in which GB distended, 5 cases were converted to open , the statistical analysis also shows this difference to be significant with a p value of 0.001, GB wall thickness – 37 cases in which the GB wall thickness was < 3mm , it was possible to do surgery in laparoscopic itself. Of the remaining 13 cases in which GB was thickened , 5 cases were converted to open , the statistical analysis also shows this difference to be significant with a p value of 0.001, number of stones alone is not significant factor to predict conversion into open, pericholecystic collection – 39 cases in which pericholecystic collection was not there , it was possible to do surgery in laparoscopic itself, of the remaining 11 cases had pericholecystic collection , 5 cases were converted to open, the statistical analysis also shows this difference to be significant with a p value of 0.001,stone size – 46 cases in which stones were <5mm, 3 cases were converted, of the 3 cases in which stones were between 5mm and 1 cm, 2 cases were converted to open . the one case stone > 1cm was done by laparoscopic , the statistical analysis also shows this difference to be significant with a p value of 0.003 CONCLUSION: In our study noted that as the USG score increases the chance of the cases being opened increases and all the opened cases had either score 11 or 12 , the statistical analysis also shows the difference to be significant with a p value of 0.001, among the USG factors , a distended GB, increased GB wall thickness, presence of pericholecystic collection ,large size stones proved to be significant and was associated with increased risk of conversion to open cholecystectomy

Item Type: Thesis (Masters)
Uncontrolled Keywords: GB - gall bladder ; USG - ultrasonogram.
Subjects: MEDICAL > General Surgery
Depositing User: Subramani R
Date Deposited: 27 Sep 2017 01:16
Last Modified: 27 Sep 2017 01:16
URI: http://repository-tnmgrmu.ac.in/id/eprint/3368

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