Abstract
Background: When we began laparoscopic cholecystectomy (LC) we set up a strict preoperative workup in order to assess whether currently available investigations could help predict difficult laparoscopic procedures.
Methods: Reported here are the results of a prospective trial carried out in our first 200 consecutive patients, who underwent routine intravenous cholangiography (IVC), abdominal ultrasound scan (US), blood tests—namely, markers of biliary stasis (MBS)—and preoperative endoscopic retrograde cholangiopancreatography (ERCP) in case of clinically suspected common bile duct stones (CBDS).
Results: On the basis of our experience we think that the US findings relate to the difficulty of the laparoscopic procedure more closely than the other preoperative investigations, and the association of US and liver chemistry provides an accurate evaluation of biliary stones.
Conclusions: In agreement with data emerging from the literature, the preoperative investigations do not seem to be useful in predicting biliary and vascular complications, whose prevention lies in the adoption of correct surgical technique and a low threshold for conversion.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Cuschieri A, Dubois F, Mouiet J, Becker H, Buess G, Trode M, Troidl H (1991) The European experience with laparoscopic cholecystectomy. Am J Surg 161: 385–387
Crist DW, Gadacz TR (1993) Complications of laparoscopic surgery. Surg Clin North Am 74(2): 265–289
Dubois F, Berthelot G, Levard H (1991) Laparoscopic cholecystectomy: historic perspective and personal experience. Surg Laparosc Endosc 1(1): 52–57
Evrard S, Dondelinger RF, Mutter D, Vix M, Mendoza-Burgos L, Marescaux J (1993) Graves complications après cholécystectomie par coelioscopie: leçons d'hier et d'aujourd'hui. J Chir (Paris) 130(5): 215–217
Fink AS (1993) To ERCP or not to ERCP? That is the question. [Editorial] Surg Endosc 7: 375–376
Ress AM, Sarr MG, Nagorney DM, Farnell MB, Donohue JH, Meilrath DC (1993) Spectrum and management of major complications of laparoscopic cholecystectomy. Am J Surg 165: 655–662
Spaw AT, Eddie JR, Olsen DO (1991) Laparoscopic laser cholecystectomy: analysis of 500 procedures. Surg Laparosc Endosc 1(1): 2–7
Zar (1984) Biostatistical analysis. Prentice-Hall, New York, pp 395–396
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Urbano, D., Di Nardo, R., De Simone, P. et al. The role of preoperative investigations in predicting difficult laparoscopic cholecystectomies. Surg Endosc 10, 791–793 (1996). https://doi.org/10.1007/BF00189534
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00189534