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Predictive factors and importance of Critical View of Safety in difficult elective laparoscopic cholecystectomy

Year 2022, Volume: 39 Issue: 3, 874 - 878, 30.08.2022

Abstract

Abstract
Knowing the surgical anatomy and related variations, revealing the factors that indicate difficult cholecystectomy, knowing and applying various safe surgical cholecystectomy techniques and guidelines recommended to prevent injuries can prevent complications. This study, it is aimed to evaluate the preoperative factors that will predict difficult elective cholecystectomy.
We retrospectively analyzed the data of patients treated for cholelithiasis by an experienced hepatobiliary surgeon or under his supervision between March 2018 and March 2020. Clinical, laboratory, and imaging data obtained from patients' files were evaluated.
According to the Modified Nassar Scale (MNS), 140 (79.5%) patients were considered grade 1-2 (easy) and 36 (20.5%) grade 3-5 (difficult) patients within the framework of intraoperative findings. Critical View of Safety was successfully performed in 170 (96.6%) of the patients. Converting laparoscopic cholecystectomy to open was performed in two (1.1%) patients who had an MNS of 4 and 5. The most common comorbidity was hypertension.
Male gender, previous cholecystitis and ERCP, and increased gall bladder wall thickness from preoperative USG findings are independent risk factors for difficult cholecystectomy in patients scheduled for laparoscopic cholecystectomy. In addition, it should be kept in mind that LC can be difficult in patients with hypertension and coronary artery disease.

References

  • 1. Tongyoo A, Chotiyasilp P, Sriussadaporn E, Limpavitayaporn P, Mingmalairak C. The pre-operative predictive model for difficult elective laparoscopic cholecystectomy: A modification. Asian J Surg. 2021; 44(4): 656-661.
  • 2. Sgaramella LI, Gurrado A, Pasculli A, de Angelis N, Memeo R, Prete FP, et al. The critical view of safety during laparoscopic cholecystectomy: Strasberg Yes or No? An Italian Multicentre study. Surg Endosc. 2021; 35(7): 3698-3708.
  • 3. Nassar AHM, Ng HJ, Wysocki AP, Khan KS, Gil IC. Achieving the critical view of safety in the difficult laparoscopic cholecystectomy: a prospective study of predictors of failure. Surg Endosc. 2021; 35(11): 6039-6047.
  • 4. Abbasoğlu O, Tekant Y, Alper A, Aydın Ü, Balık A, Bostancı B, et al. Prevention and acute management of biliary injuries during laparoscopic cholecystectomy: Expert consensus statement. Ulus Cerrahi Derg. 2016; 32(4): 300-305.
  • 5. Strasberg SM. A three-step conceptual road map for avoiding bile duct injury in laparoscopic cholecystectomy: an invited perspective review. J Hepatobiliary Pancreat Sci. 2019; 26(4): 123-127.
  • 6. Bhandari TR, Khan SA, Jha JL. Prediction of difficult laparoscopic cholecystectomy: An observational study. Ann Med Surg (Lond). 2021; 72: 103060.
  • 7. Strasberg SM, Brunt LM. Rationale and use of the critical view of safety in laparoscopic cholecystectomy. J Am Coll Surg. 2010; 211(1): 132-138.
  • 8. Gupta V, Jain G. Safe laparoscopic cholecystectomy: Adoption of universal culture of safety in cholecystectomy. World J Gastrointest Surg. 2019; 11(2): 62-84.
  • 9. Sutcliffe RP, Hollyman M, Hodson J, Bonney G, Vohra RS, Griffiths EA, et al. Preoperative risk factors for conversion from laparoscopic to open cholecystectomy: a validated risk score derived from a prospective U.K. database of 8820 patients. HPB (Oxford). 2016; 18(11): 922-928.
  • 10. Bharamgoudar R, Sonsale A, Hodson J, Griffiths E; CholeS Study Group, West Midlands Research Collaborative. The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy. Surg Endosc. 2018; 32(7): 3149-3157.
  • 11. Nassar AHM, Hodson J, Ng HJ, Vohra RS, Katbeh T, Zino S, et al. Predicting the difficult laparoscopic cholecystectomy: development and validation of a pre-operative risk score using an objective operative difficulty grading system. Surg Endosc. 2020; 34(10): 4549-4561.
  • 12. Griffiths EA, Hodson J, Vohra RS, Marriott P, Katbeh T, Zino S, et al. Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy. Surg Endosc. 2019; 33(1): 110-121.
  • 13. Van de Graaf FW, Zaïmi I, Stassen LPS, Lange JF. Safe laparoscopic cholecystectomy: A systematic review of bile duct injury prevention. Int J Surg. 2018; 60: 164-172.
  • 14. Kaya B, Fersahoglu MM, Kilic F, Onur E, Memisoglu K. Importance of critical view of safety in laparoscopic cholecystectomy: a survey of 120 serial patients, with no incidence of complications. Ann Hepatobiliary Pancreat Surg. 2017; 21(1): 17-20.
  • 15. Zarin M, Khan MA, Khan MA, Shah SAM. Critical view of safety faster and safer technique during laparoscopic cholecystectomy? Pak J Med Sci. 2018; 34(3): 574-577.
  • 16. Da Costa DW, Schepers NJ, Bouwense SA, Hollemans RA, vanSantvoort HC, Bollen TL, et al. Predicting a ‘difficult cholecystectomy’ after mild gallstone pancreatitis. HPB 2018; 21: 827-833.
  • 17. Wenzel UO, Bode M, Köhl J, Ehmke H. A pathogenic role of complement in arterial hypertension and hypertensive end organ damage. Am J Physiol Heart Circ Physiol. 2017; 312(3): 349-354.
  • 18. Beliaev AM, Angelo N, Booth M, Bergin C. Evaluation of neutrophil-to-lymphocyte ratio as a potential biomarker for acute cholecystitis. J Surg Res. 2017; 209: 93-101.
  • 19. Kler A, Taib A, Hajibandeh S, Hajibandeh S, Asaad P. The predictive significance of neutrophil-to-lymphocyte ratio in cholecystitis: a systematic review and meta-analysis. Langenbecks Arch Surg. 2022; 407(3): 927-935.
Year 2022, Volume: 39 Issue: 3, 874 - 878, 30.08.2022

Abstract

References

  • 1. Tongyoo A, Chotiyasilp P, Sriussadaporn E, Limpavitayaporn P, Mingmalairak C. The pre-operative predictive model for difficult elective laparoscopic cholecystectomy: A modification. Asian J Surg. 2021; 44(4): 656-661.
  • 2. Sgaramella LI, Gurrado A, Pasculli A, de Angelis N, Memeo R, Prete FP, et al. The critical view of safety during laparoscopic cholecystectomy: Strasberg Yes or No? An Italian Multicentre study. Surg Endosc. 2021; 35(7): 3698-3708.
  • 3. Nassar AHM, Ng HJ, Wysocki AP, Khan KS, Gil IC. Achieving the critical view of safety in the difficult laparoscopic cholecystectomy: a prospective study of predictors of failure. Surg Endosc. 2021; 35(11): 6039-6047.
  • 4. Abbasoğlu O, Tekant Y, Alper A, Aydın Ü, Balık A, Bostancı B, et al. Prevention and acute management of biliary injuries during laparoscopic cholecystectomy: Expert consensus statement. Ulus Cerrahi Derg. 2016; 32(4): 300-305.
  • 5. Strasberg SM. A three-step conceptual road map for avoiding bile duct injury in laparoscopic cholecystectomy: an invited perspective review. J Hepatobiliary Pancreat Sci. 2019; 26(4): 123-127.
  • 6. Bhandari TR, Khan SA, Jha JL. Prediction of difficult laparoscopic cholecystectomy: An observational study. Ann Med Surg (Lond). 2021; 72: 103060.
  • 7. Strasberg SM, Brunt LM. Rationale and use of the critical view of safety in laparoscopic cholecystectomy. J Am Coll Surg. 2010; 211(1): 132-138.
  • 8. Gupta V, Jain G. Safe laparoscopic cholecystectomy: Adoption of universal culture of safety in cholecystectomy. World J Gastrointest Surg. 2019; 11(2): 62-84.
  • 9. Sutcliffe RP, Hollyman M, Hodson J, Bonney G, Vohra RS, Griffiths EA, et al. Preoperative risk factors for conversion from laparoscopic to open cholecystectomy: a validated risk score derived from a prospective U.K. database of 8820 patients. HPB (Oxford). 2016; 18(11): 922-928.
  • 10. Bharamgoudar R, Sonsale A, Hodson J, Griffiths E; CholeS Study Group, West Midlands Research Collaborative. The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy. Surg Endosc. 2018; 32(7): 3149-3157.
  • 11. Nassar AHM, Hodson J, Ng HJ, Vohra RS, Katbeh T, Zino S, et al. Predicting the difficult laparoscopic cholecystectomy: development and validation of a pre-operative risk score using an objective operative difficulty grading system. Surg Endosc. 2020; 34(10): 4549-4561.
  • 12. Griffiths EA, Hodson J, Vohra RS, Marriott P, Katbeh T, Zino S, et al. Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy. Surg Endosc. 2019; 33(1): 110-121.
  • 13. Van de Graaf FW, Zaïmi I, Stassen LPS, Lange JF. Safe laparoscopic cholecystectomy: A systematic review of bile duct injury prevention. Int J Surg. 2018; 60: 164-172.
  • 14. Kaya B, Fersahoglu MM, Kilic F, Onur E, Memisoglu K. Importance of critical view of safety in laparoscopic cholecystectomy: a survey of 120 serial patients, with no incidence of complications. Ann Hepatobiliary Pancreat Surg. 2017; 21(1): 17-20.
  • 15. Zarin M, Khan MA, Khan MA, Shah SAM. Critical view of safety faster and safer technique during laparoscopic cholecystectomy? Pak J Med Sci. 2018; 34(3): 574-577.
  • 16. Da Costa DW, Schepers NJ, Bouwense SA, Hollemans RA, vanSantvoort HC, Bollen TL, et al. Predicting a ‘difficult cholecystectomy’ after mild gallstone pancreatitis. HPB 2018; 21: 827-833.
  • 17. Wenzel UO, Bode M, Köhl J, Ehmke H. A pathogenic role of complement in arterial hypertension and hypertensive end organ damage. Am J Physiol Heart Circ Physiol. 2017; 312(3): 349-354.
  • 18. Beliaev AM, Angelo N, Booth M, Bergin C. Evaluation of neutrophil-to-lymphocyte ratio as a potential biomarker for acute cholecystitis. J Surg Res. 2017; 209: 93-101.
  • 19. Kler A, Taib A, Hajibandeh S, Hajibandeh S, Asaad P. The predictive significance of neutrophil-to-lymphocyte ratio in cholecystitis: a systematic review and meta-analysis. Langenbecks Arch Surg. 2022; 407(3): 927-935.
There are 19 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Clinical Research
Authors

Haldun Kar 0000-0001-7710-0665

Arif Atay 0000-0001-8163-2357

Early Pub Date August 30, 2022
Publication Date August 30, 2022
Submission Date July 12, 2022
Acceptance Date July 20, 2022
Published in Issue Year 2022 Volume: 39 Issue: 3

Cite

APA Kar, H., & Atay, A. (2022). Predictive factors and importance of Critical View of Safety in difficult elective laparoscopic cholecystectomy. Journal of Experimental and Clinical Medicine, 39(3), 874-878.
AMA Kar H, Atay A. Predictive factors and importance of Critical View of Safety in difficult elective laparoscopic cholecystectomy. J. Exp. Clin. Med. August 2022;39(3):874-878.
Chicago Kar, Haldun, and Arif Atay. “Predictive Factors and Importance of Critical View of Safety in Difficult Elective Laparoscopic Cholecystectomy”. Journal of Experimental and Clinical Medicine 39, no. 3 (August 2022): 874-78.
EndNote Kar H, Atay A (August 1, 2022) Predictive factors and importance of Critical View of Safety in difficult elective laparoscopic cholecystectomy. Journal of Experimental and Clinical Medicine 39 3 874–878.
IEEE H. Kar and A. Atay, “Predictive factors and importance of Critical View of Safety in difficult elective laparoscopic cholecystectomy”, J. Exp. Clin. Med., vol. 39, no. 3, pp. 874–878, 2022.
ISNAD Kar, Haldun - Atay, Arif. “Predictive Factors and Importance of Critical View of Safety in Difficult Elective Laparoscopic Cholecystectomy”. Journal of Experimental and Clinical Medicine 39/3 (August 2022), 874-878.
JAMA Kar H, Atay A. Predictive factors and importance of Critical View of Safety in difficult elective laparoscopic cholecystectomy. J. Exp. Clin. Med. 2022;39:874–878.
MLA Kar, Haldun and Arif Atay. “Predictive Factors and Importance of Critical View of Safety in Difficult Elective Laparoscopic Cholecystectomy”. Journal of Experimental and Clinical Medicine, vol. 39, no. 3, 2022, pp. 874-8.
Vancouver Kar H, Atay A. Predictive factors and importance of Critical View of Safety in difficult elective laparoscopic cholecystectomy. J. Exp. Clin. Med. 2022;39(3):874-8.