Bharamgoudar et al reported a score for predicting the duration of an elective laparoscopic cholecystectomy. This can help to identify a case that may take a longer period of time. The authors are from the University of Birmingham and University Hospitals Birmingham NHS Foundation Trust.
Patient selection: elective laparoscopic cholecystectomy
Outcome: case duration > 90 minutes
Parameters:
(1) age in years
(2) gender
(3) indication for surgery
(4) body mass index (BMI) in kilograms per square meter
(5) common bile duct diameter in mm
(6) gallbladder wall
(7) pre-operative CT scan
(8) planned intra-operative cholangiogram
(9) number of previous surgical admissions
(10) ASA status
Parameter |
Finding |
Points |
age in years |
< 40 |
0 |
|
>= 40 |
1.5 |
gender |
female |
0 |
|
male |
1 |
indication |
pancreatitis |
0 |
|
colic, dyskinesia |
0.5 |
|
polyp |
0.5 |
|
common bile duct stone |
2 |
|
acalculus |
2.5 |
|
cholecystitis |
2.5 |
BMI |
< 25 |
0 |
|
25 to 35 |
1 |
|
> 35 |
2 |
common bile duct diameter |
normal |
0 |
|
dilated |
2 |
gallbladder wall |
normal |
0 |
|
thick |
1.5 |
pre-operative CT scan |
no |
0 |
|
yes |
1.5 |
planned cholangiogram |
no |
0 |
|
yes |
3 |
number of previous surgical admissions |
0 |
0 |
|
1 or 2 |
1 |
|
>= 3 |
2.5 |
ASA |
1 |
0 |
|
2 |
1 |
|
>= 3 |
2.5 |
total score =
= SUM(points for all 10 parameters)
Interpretation:
• minimum score: 0
• maximum score: 20
• The higher the score the more likely that it would take more than 90 minutes.
Performance:
• The area under the ROC curve is 0.71.
Specialty: Gastroenterology