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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Intra-operative gallbladder scoring predicts conversion of laparoscopic to open cholecystectomy: A WSES prospective collaborative study
World Journal of Emergency Surgery, Volume 14, No. 1, Article 12, Year 2019
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Description
Introduction: Laparoscopic cholecystectomy, the gold-standard approach for cholecystectomy, has surprisingly variable outcomes and conversion rates. Only recently has operative grading been reported to define disease severity and few have been validated. This multicentre, multinational study assessed an operative scoring system to assess its ability to predict the need for conversion from laparoscopic to open cholecystectomy. Methods: A prospective, web-based, ethically approved study was established by WSES with a 10-point gallbladder operative scoring system; enrolling patients undergoing elective or emergency laparoscopic cholecystectomy between January 2016 and December 2017. Gallbladder surgery was considered easy if the G10 score < 2, moderate (2 ≦ 4), difficult (5 ≦ 7) and extreme (8 ≦ 10). Demographics about the patients, surgeons and operative procedures, use of cholangiography and conversion rates were recorded. Results: Five hundred four patients, mean age 53.5 (range 18-89), were enrolled by 55 surgeons in 16 countries. Surgery was performed by consultants in 70% and was elective in (56%) with a mean operative time of 78.7 min (range 15-400). The mean G10 score was 3.21, with 22% deemed to have difficult or extreme surgical gallbladders, and 71/504 patients were converted. The G10 score was 2.98 in those completed laparoscopically and 4.65 in the 71/504 (14%) converted. (p < 0.0001; AUC 0.772 (CI 0.719-0.825). The optimal cut-off point of 0.067 (score of 3) was identified in G10 vs conversion to open cholecystectomy. Conversion occurred in 33% of patients with G10 scores of ≥ 5. The four variables statistically predictive of conversion were GB appearance - completely buried GB, impacted stone, bile or pus outside GB and fistula. Conclusion: The G10 operative scores provide simple grading of operative cholecystectomy and are predictive of the need to convert to open cholecystectomy. Broader adaptation and validation may provide a benchmark to understand and improve care and afford more standardisation in global comparisons of care for cholecystectomy. © 2019 The Author(s).
Authors & Co-Authors
Sugrue, Michael E.
Ireland, Donegal
Letterkenny University Hospital
Coccolini, Federico
Italy, Bergamo
Papa Giovanni Xxiii Hospital
Bucholc, Magda
United Kingdom, Coleraine
Ulster University
Johnston, Alison
Ireland, Donegal
Letterkenny University Hospital
Manatakis, Dimitrios K.
Unknown Affiliation
Ioannidis, Orestis M.
Unknown Affiliation
Bonilauri, Stefano
Unknown Affiliation
Gachabayov, Mahir
Unknown Affiliation
Isik, Arda A.
Unknown Affiliation
Ghnnam, Wagih Mommtaz
Unknown Affiliation
Shelat, Vishal Girishchandra
Unknown Affiliation
Mohan, Rajashekar
Unknown Affiliation
Montori, Giulia
Unknown Affiliation
Walędziak, Maciej Stanisław
Unknown Affiliation
Kong, Victor Yeewai
Unknown Affiliation
Fugazzola, Paola
Unknown Affiliation
Nita, Gabriela Elisa
Unknown Affiliation
Nardi, Matteo
Unknown Affiliation
Major, Piotr
Unknown Affiliation
Negoi, Ionut
Unknown Affiliation
Di Carlo, Isidoro
Unknown Affiliation
Massalou, Damien
Unknown Affiliation
D'Amico, Giuseppe
Unknown Affiliation
Solaini, Leonardo
Unknown Affiliation
Ceresoli, Marco
Unknown Affiliation
Bini, Roberto
Unknown Affiliation
Zielinski, Martin Donald
Unknown Affiliation
Tomasoni, Matteo
Unknown Affiliation
Litvin, A. A.
Unknown Affiliation
de Simone, Belinda D.
Unknown Affiliation
Lostoridis, Eftychios
Unknown Affiliation
Hernández, Fernando
Unknown Affiliation
Machain Vega, Gustavo Miguel
Unknown Affiliation
Baiocchi, Gian Luca
Unknown Affiliation
Ansaloni, Luca
Unknown Affiliation
Sartelli, Massimo
Unknown Affiliation
León-Arellano, Miguel
Unknown Affiliation
Statistics
Citations: 39
Authors: 37
Affiliations: 3
Identifiers
Doi:
10.1186/s13017-019-0230-9
ISSN:
17497922
Research Areas
Health System And Policy
Study Design
Cohort Study