To Determine Predictive Factors For Difficult Laproscopic Cholecystectomy Using Ultrasonography Criteria

Muhammad Kashif, Zia Ullah, Muhammad Ali, Muhammad Ibrahim Shuja,
Faiz ur Rahman and Aamir Ali Khan

ABSTRACT

Objective: The aim of the study was to find out the predictive factors for difficult laproscopic cholecystectomy using ultrasonographic criteria.

Study Design: cross-sectional study

Place and Duration of Study: This study was conducted at the department of Bacha Khan Medical Complex/Gajju Khan Medical College-SWABI from July 2022 to December 2022.

Methods: After taking permission from the ethical committee of the institute. A total of 154 individuals were enrolled in this study.  Individuals of both genders diagnosed with cholelithiasis and were admitted for laparoscopic cholecystectomy were included. Gallbladder wall thickness, impacted stone, number of gallstones, pericholecystic fluid, , and constricted gall bladder  were the main  features examined by ultrasonography . All the data were analyzed using SPSS version 24. A P value was regarded as statistically significant if it was less than 0.05. Ultrasonography's diagnostic effectiveness indices, including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy, were tested.

Results: Out of 154 individuals, 31 (20.1%) were male and 123 (79.87%) were female. The presence of pericholecystic fluid on ultrasonography, gall bladder wall thickness greater than 4 mm and stone size were the main the predictors of a difficult  laparoscopic cholecystectomy. The difficult laparoscopic cholecystectomy was predicted by sensitivity, specificity, positive predictive value, negative predictive value, and probing precision of gall bladder wall thickness greater than 4 mm and pericholecystic fluid on ultrasonography. The number of gall stones on ultrasonography demonstrated 96.5%, sensitivity, 75% specificity, 99.3%, and PPV 37.5%, NPV and 96% diagnostic accuracy.

Conclusion: Our study concluded that Ultrasonography should be used as a screening method because it is a very good indicator in difficult laparoscopic cholecystectomy in the majority of the participants. This can assist the surgeon in anticipating any possible issues that may arise during surgery.

Key Words: Predictive factors, Difficult laproscopic cholecystectomy; Ultrasonographic criteria

Citation of article: Kashif M, Zia Ullah, Ali M, Shuja MI, Faiz ur Rahman, Khan AA, To Determine Predictive Factors For Difficult Laproscopic Cholecystectomy Using Ultrasonography Criteria. Med Forum 2024;35(10):36-40. doi:10.60110/medforum.351009.