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Parkland Grading Scheme for Cholecystitis

Description

Madni et al reported the Parkland grading scale for cholecystitis. This can help to stratify factors impacting surgical complexity, duration and complications. The authors are from the University of Texas Southwestern and University of California at Davis.


Patient selection: cholecystitis

 

The normal gallbladder is described as being robin's egg blue at laparoscopy.

 

Parameters:

(1) overall appearance

(2) adhesions

(3) anatomical issues

 

Description

Grade

normal appearing without adhesions

1

minor adhesions around gallbladder neck

2

any of the following: hyperemia, distension, adhesions to body, pericholecystic fluid

3

any of the following: adhesions obscuring the majority of the gallbladder, abnormal liver anatomy, intrahepatic gallbladder, impacted gallstone (Mirrizi)

4

any of the following: perforation, necrosis/gangrene, inability to visualize gallbladder due to adhesions

5

 


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