Validation of Nassar Difficulty Grading Scale in Predicting Difficult Laparoscopic Cholecystectomy | ||||
| Ain Shams Journal of Surgery | ||||
| Volume 16, Issue 2, April 2023, Page 110-129 PDF (678.59 K) | ||||
| DOI: 10.21608/asjs.2023.298749 | ||||
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| Author | ||||
Sameh Hashish
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| Department of Hepatobiliary & Liver Transplant Surgery, National Liver Institute, Menofia University, Menofia, Egypt | ||||
| Abstract | ||||
| Background: Cholelithiasis is a common disease & laparoscopic cholecystectomy is the gold standard treatment for cholecystitis. There is a need for a preoperative scoring system that can accurately predict difficult laparoscopic cholecystectomies to assist in selection of patients as a day case surgery, to assign the procedure to a surgeon with the appropriate experience and to counsel the patient throughout the consent process. The aim of this study: To validate Nassar preoperative scoring system that would predict difficult laparoscopic cholecystectomies. conversion to open cholecystectomy was considered the primary end point of difficulty. Patients and methods: This was a prospective cohort study to patients who underwent laparoscopic cholecystectomies at our department of surgery, King Abdul-Aziz specialized hospital (KAASH) at Taif, Ministry of health, Saudi Arabia between April 2020, and April 2022. Results: 1357 patients underwent laparoscopic cholecystectomy whether elective or emergent. After admission of patients to operative theatre for laparoscopic cholecystectomy, 478 (35.2%) of patients were converted to open to complete the procedure. Patients & percentages of difficult operations were classified according to Nassar risk score from 0 to 19 & then, subdividing all risk scores into 3 subgroups: low, medium & high-risk score. It was found that 56% of preoperative high-risk patients (7-19) had difficult operations, while 24.4% of medium-risk patients (2-6) had difficult operations & only 10.1% of patients of Low-risk group had difficult procedures. Conclusion: Nassar difficulty grading scale is considered straightforward, clinically & surgically applicable, and easy to use preoperative scoring system to predict difficult laparoscopic cholecystectomies. | ||||
| Keywords | ||||
| Cholecystitis; difficult cholecystectomy; Nassar score | ||||
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