DURATION OF CYSTIC DUCT DISSECTION AS AN INDICATOR OF CHALLENGING LAPAROSCOPIC CHOLECYSTECTOMY.

Abstract

Background:

The Tokyo 2018 guidelines recommend investigating quantitative predictors of surgical complexity in laparoscopic cholecystectomy to ensure safe and effective gallbladder removal.

Objective: This study aims to evaluate the duration of cystic duct (CD) dissection as a potential indicator of surgical complexity.

Materials and Methods:

A prospective study with 190 individuals scheduled for laparoscopic cholecystectomy was carried out. Depending on the reason for the cholecystectomy, people were divided into three categories: elective, delayed, and urgent. The study utilized both multinomial logistic regression and multiple linear regression analysis to determine the preoperative and operative predictive variables associated with surgical difficulties.

Results:

The duration of CD dissection was observed to be 12 minutes, exhibiting a sensitivity of 100% and specificity of 99%. The positive predictive value (PPV) was determined to be 100%, while the negative predictive value (NPV) was found to be 1%. The odds ratio (OR) was calculated to be 2.3, indicating a predictive capacity for the utilization of bailout techniques.

Conclusion:

The duration of cystic duct dissection, regardless of its outcome, serves as a practical indicator for the likelihood of employing bailout procedures and thus predicts the probability of encountering a "Risk/Difficult Cholecystectomy".