Gallbladder adhesion degree as predictor of conversion surgery, common bile duct injury and resurgery in laparoscopic cholecystectomy: A cross-sectional study

Adeodatus Yuda Handaya; Victor Agastya Pramudya Werdana; Aditya Rifqi Fauzi; Joshua Andrew; Ahmad Shafa Hanif; Kevin Radinal Tjendra; Azriel Farrel Kresna Aditya

doi:10.1016/j.amsu.2021.102631

Gallbladder adhesion degree as predictor of conversion surgery, common bile duct injury and resurgery in laparoscopic cholecystectomy: A cross-sectional study

Ann Med Surg (Lond). 2021 Jul 30:68:102631. doi: 10.1016/j.amsu.2021.102631. eCollection 2021 Aug.

Authors

Adeodatus Yuda Handaya¹, Victor Agastya Pramudya Werdana¹, Aditya Rifqi Fauzi¹, Joshua Andrew¹, Ahmad Shafa Hanif¹, Kevin Radinal Tjendra¹, Azriel Farrel Kresna Aditya¹

Affiliation

¹ Digestive Surgery Division, Department of Surgery, Faculty of Medicine, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta 55281, Indonesia.

Abstract

Background: The gold-standard treatment for cholecystectomy, laparoscopic cholecystectomy, has remarkably variable outcomes and conversion rates. We investigated the gallbladder adhesion degree as a predictor of conversion surgery, common bile duct injury, and resurgery.

Methods: We reviewed 157 medical records and video recordings of laparoscopic cholecystectomy on patients with cholelithiasis with or without cholecystitis at three hospitals in Yogyakarta, Indonesia from January 2016 to December 2018. The degree of gallbladder adhesion is classified into 4 categories: no adhesion, <50% adhesion, 50%-buried GB, and completely buried GB.

Results: One hundred fifty seven patients were involved in this study, of whom 58 were males and 99 females with average age 49.2. Eighty-one patients out of 157 patients (51.6%) had gallbladder adhesion comprising of 61/157 (38.9%) with <50% adhesion and 20/157 (12.7%) 50%-buried GB. There is one incidence each of conversion surgery, CBD injury, and resurgery. The degree of GB adhesion has low degree of correlation with conversion surgery, CBD injury, and resurgery wirh r value of 0.156, 0.041, and 0.156 respectively. There is significant correlation between the degree of GB adhesion and conversion surgery and resurgery with p value of 0.032, and 0.032 respectively. There is no significant correlation between degree of GB adhesion and CBD injury with p value of 0.453.

Conclusion: The degree of GB adhesion has low degree of correlation with conversion, CBD injury and resurgery. This study also showed that patients with high degree of gallbladder adhesion are still eligible for laparoscopic procedure performed by an experienced surgeon.

Keywords: Common bile duct injury; Conversion; Gallbladder adhesion degree; Laparoscopic cholecystectomy; Resurgery.