Relación entre hallazgos ecográficos preoperatorios y quirúrgicos, con la dificultad de la colecistectomía laparoscópica. Hospital Homero Castanier Crespo-Azogues.2014

Abstract

Introduction: Abdominal ultrasound is the main diagnostic aid in the vesicular gallstones. The laparoscopic surgery is the surgical procedure of choice. Technical difficulties involve risks of intra- and postcholecystectomy complications.

Objective: To determine the relationship of sonographic classification and surgical findings with technical problems for the prediction of difficult laparoscopic cholecystectomy and risk of perioperative complications.

Materials and Methods: An observational, analytical, cross-sectional study was made in patients who were submitted to a laparoscopic surgery from June to September 2014, in the Homero Castanier Crespo Hospital in Azogues city by comparing proportions with p <0.05 as significant.

Results: A total of 82 women (76.6%) and 25 men (23.4%) were studied. Their average age was 39.9 years with a SD of 14.74. Ultrasound diagnostic agreement and intraoperative findings was 82.2%. The adhesions to the gallbladder (77.6%), dissection of Calot's triangle (44.9%), dissection of the gallbladder bed (39.3%), they were the major difficulties. In the Braghetto classification, the grades IIA, IIB and III had higher percentage of difficulty.

Conclusions: It was demonstrated that the technical difficulty increases progressively in IIA, IIB and III types from the Braghetto classification.