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Effect of Duration of Calot’s Triangle Dissection on the Definition of Difficult Cholecystectomy
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Original Investigation
VOLUME: 9 ISSUE: 1
P: 22-26
April 2019

Effect of Duration of Calot’s Triangle Dissection on the Definition of Difficult Cholecystectomy

J Acad Res Med 2019;9(1):22-26
DOI: 10.5152/jarem.2019.2388
Emin Köse
1. Department of General Surgery, University of Health Sciences Okmeydanı Training and Research Hospital, İstanbul, Turkey
No information available.
No information available
Received Date: 12.08.2018
Accepted Date: 15.09.2018
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ABSTRACT

Conclusion:

The failure to complete Calot’s triangle within a specified time during elective cholecystectomy procedures can be considered as a difficult cholecystectomy criterion.

Results:

The mean age of patients was 50.6±14 years; 203 (68%) were female and 97 (32%) were male. A total of 25 patients (8%) were considered to have difficult cholecystectomy (Group 1). There was a statistically significant difference between the groups in terms of gender (p=0.002), acute cholecystitis (p=0.009), and acute cholangitis history (p=0.009). Calot’s dissection duration and operation time were significantly longer in Group 1 (p=0.0001 and p=0.0001, respectively). Calot’s dissection optimum time was defined as 15 minutes (72% sensitivity and 84.7% specificity) in patients who were considered to have difficult cholecystectomy. There was a significant correlation between the duration of Calot’s dissection time that was longer than 15 minutes and the occurrence of difficult cholecystectomy (p=0.0001).

Methods:

A retrospective analysis was performed in patients who were diagnosed with cholelithiasis and planned for laparoscopic cholecystectomy between March 2015 and November 2016. Demographic and clinical data (previous operation history, acute cholecystitis, a history of cholangitis and pancreatitis, history of endoscopic retrograde cholangiopancreatography, and Calot’s dissection duration and total operation time) were collected from 300 patients involved in the study. A total operation time lasting 120 minutes and longer, switching to open cholecystectomy from the laparoscopic technique, and intraoperative complication related with cholecystectomy (biliary injury, uncontrolled blooding) were chosen as difficult cholecystectomy and named as Group 1. All other patients out of these findings were put in as Group 2. The factors that caused difficult cholecystectomy were analyzed statistically.

Objective:

The aim of the study was to investigate the effect of Calot’s triangle dissection time on switching from elective laparoscopic cholecystectomy to open cholecystectomy, prolonged operation time (≥120min), and prediction of the difficulty associated with complications development.