Predicting Difficulty in Laparoscopic Cholecystectomies: An Evaluation of the Labbad-Vivas Score and Its Correlation With the Parkland Grading Scale.

Autor:	Serrano-González R; Department of Surgery, Universidad de Oriente Núcleo Anzoátegui, Barcelona, VEN., Rivero Y; Department of Surgery, Universidad de Oriente Núcleo Anzoátegui, Barcelona, VEN., Hernandez-Velasquez A; Department of Surgery, Universidad de Oriente Núcleo Anzoátegui, Barcelona, VEN., Rodriguez-Rugel T; Department of Surgery, Universidad Católica de Santiago de Guayaquil, Guayaquil, ECU., Mendez-Meneses G; Department of Surgery, Universidad de Oriente Núcleo Anzoátegui, Barcelona, VEN., Vidal-Gallardo A; Medico Cirujano, Universidad de los Andes, Merida, VEN., Garcia-Sánchez E; Department of Surgery, Universidad de Oriente Núcleo Anzoátegui, Barcelona, VEN., Gonzalez-Quinde G; Department of Surgery, Hospital Leon Becerra Camacho, Milagro, ECU., Antigua-Herrera J; Department of Surgery, Instituto Tecnológico de Santo Domingo, Santo Domingo, DOM., Zelaya-Ochoa Y; Department of Surgery, Universidad de El Salvador, San Salvador, SLV., Paz-Castillo M; Department of Surgery, Universidad de Oriente Núcleo Anzoátegui, Barcelona, VEN.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Mar 14; Vol. 16 (3), pp. e56185. Date of Electronic Publication: 2024 Mar 14 (Print Publication: 2024).
DOI:	10.7759/cureus.56185
Abstrakt:	Background Difficult laparoscopic cholecystectomy (DLC) denotes the surgical extraction of the gallbladder under circumstances where associated conditions within the same organ, adjacent structures, or patient-specific conditions impede a smooth, expeditious, and comfortable dissection. It is imperative to utilize tools that aid in anticipating this challenging surgical scenario, enabling the implementation of appropriate measures. Objective This study aimed to assess the effectiveness of the Labbad-Vivas score (LVS) in predicting DLC and its correlation with the Parkland Grading Scale (PGS). Methodology A prospective study was conducted, including patients diagnosed with gallstone disease undergoing LC (laparoscopic cholecystectomy) at the "Dr. Luis Razetti" University Hospital in Barcelona, Venezuela, between September and December 2023. Results Forty patients were studied, with 80% (n=32) being female and 95% (n=38) under the age of 65; surgeries were elective in 72.5% (n=29) of cases; 35% (n=14) had an LVS ≥16 (difficult cholecystectomy); and 62.5% (n=25) of patients presented Grades 1 and 2 on the PGS. Total cholecystectomy was performed in 95% (n=38) of the patients. The LVS showed a sensitivity of 80%, specificity of 92%, positive predictive value of 85.7%, and negative predictive value of 88.5% to predict DLC, with an area under the receiver operating characteristic curve of 0.897 (95% confidence interval (CI) = 0.792-1.003). A Pearson correlation coefficient of 0.805 (95% CI = 0.656 - 0.904) was obtained between both scores. Conclusion The use of the LVS score in the preoperative setting is feasible as a predictor of DLC, given its effectiveness and high correlation with the PGS. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2024, Serrano-González et al.)
Databáze:	MEDLINE
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