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A Retrospective and Prospective Study to Develop a Pre-operative Difficulty Score for Laparoscopic Cholecystectomy

  • 2018 SSAT Poster Presentation
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

The objectives of this study were to develop a grading system to enable pre-operative prediction of technical difficulty of laparoscopic cholecystectomy using retrospective data and to attempt to validate our scoring system prospectively.

Methods

Retrospective analysis was conducted of 100 consecutive patients. Pre-operative variables were collected based on a template devised by the American College of Surgeons. Outcomes were duration of surgery, conversion to open and post-operative complications. Multivariate analysis with subsequent measurement of hazard ratios was used to formulate a weighted grading system. Prospective analysis was performed of 100 consecutive patients who were scored pre-operatively. Outcomes were duration of surgery and length of stay.

Results

Retrospective univariate analysis identified four variables associated with an increase in duration of surgery: male gender (p = 0.023), age (p = 0.000), body mass index (BMI) (p = 0.000) and pre-operative endoscopic retrograde cholangiopancreatography (ERCP) (p = 0.001). Prospective analysis revealed weak positive correlations between the scoring system and duration of surgery (0.34) and length of stay (0.40).

Conclusion

We have identified four pre-operative variables that predicted a longer duration of surgery. Preliminary results suggest a positive correlation between this scoring system and duration of surgery. An adequately powered prospective multi-centre study is needed to validate our findings.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

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Authors and Affiliations

  1. Gwent Centre for Digestive Diseases, Royal Gwent Hospital, Newport, Wales, NP20 2UB, UK

    Yousef Ibrahim, Rami W Radwan, Ali Adel Ne’ma Abdullah, Mohamed Sherif, Usman Khalid, James Ansell & Ashraf Rasheed

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  1. Yousef Ibrahim
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  2. Rami W Radwan
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  3. Ali Adel Ne’ma Abdullah
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  4. Mohamed Sherif
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  5. Usman Khalid
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  6. James Ansell
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  7. Ashraf Rasheed
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We can confirm that all authors have been involved in:

- Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; AND- Drafting the work or revising it critically for important intellectual content; AND- Final approval of the version to be published; AND- Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Yousef Ibrahim.

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Ibrahim, Y., Radwan, R.W., Abdullah, A.A.N. et al. A Retrospective and Prospective Study to Develop a Pre-operative Difficulty Score for Laparoscopic Cholecystectomy. J Gastrointest Surg 23, 690–695 (2019). https://doi.org/10.1007/s11605-018-3821-y

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  • DOI: https://doi.org/10.1007/s11605-018-3821-y

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