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Original article
Validation of the association of the cystic duct fibrosis score with surgical difficulty in laparoscopic cholecystectomy
Hyung Hwan Moon, Ji Hoon Jo, Young Il Choi, Dong Hoon Shin
Kosin Med J. 2022;37(1):61-67.   Published online March 25, 2022
DOI: https://doi.org/10.7180/kmj.21.049
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  • 1 Citations
Abstract PDFPubReader   ePub   
Background
The level of surgical difficulty in laparoscopic cholecystectomy might be predictable based on preoperative imaging and intraoperative findings indicative of cholecystitis severity. Several scales for laparoscopic cholecystectomy have been developed, but most are complex, unverified, and not widely adopted. This study evaluated the association of the cystic duct fibrosis score (range, 0–3) with surgical difficulty in laparoscopic cholecystectomy.
Methods
Between July 2018 and November 2018, 163 laparoscopic cholecystectomy cases were retrospectively reviewed at a single center. Patients’ demographics, preoperative laboratory data, operation time, complications, hospital stay, and cholecystitis severity grade were investigated. We also evaluated the associations of the Tokyo Guidelines 2018 and the Parkland grading scale with the cystic fibrosis score.
Results
The cystic duct fibrosis score was associated with preoperative white blood cells (p<0.001), preoperative platelet count (p=0.046), preoperative total bilirubin (p<0.004), preoperative C-reactive protein (p<0.001), operation time (p<0.001), cystic duct ligation time (p=0.002), estimated blood loss (p<0.001), postoperative complication (p=0.004), open conversion (p<0.001), and common bile duct injury (p=0.010). The cystic duct fibrosis score was also correlated with the Tokyo Guidelines 2018 and the Parkland grading scale (p<0.001). The cystic duct ligation time predicted the cystic duct fibrosis score and the Parkland grading scale, but not the Tokyo Guidelines 2018.
Conclusion
As a simple indicator of cholecystitis severity, the cystic duct fibrosis score can predict the surgical difficulty and outcomes of laparoscopic cholecystectomy.

Citations

Citations to this article as recorded by  
  • Correlation Between Preoperative Ultrasonography and Parkland Grading Scale in Patients Undergoing Laparoscopic Cholecystectomy
    Burak Uçaner, Doğuş Durmuş, Mehmet Zeki Buldanlı, Oğuz Hançerlioğulları
    Indian Journal of Surgery.2024; 86(1): 160.     CrossRef

KMJ : Kosin Medical Journal