DEFINITION CRITERIA FOR DIFFICULT CHOLECYSTECTOMY: SYSTEMATIC REVIEW pguerreros@unal.edu.co

 

DEFINITION CRITERIA FOR DIFFICULT CHOLECYSTECTOMY: SYSTEMATIC REVIEW

3

Colombia

Oral or Poster

Cholecystectomy is the second most common procedure to be performed by the general surgeon, presenting in many cases difficult cholecystectomies. However, there is no standardized definition of this condition, so the objective of this systematic review was to compile the definitions of difficult cholecystectomy implemented in the evidence.

A systematic review was conducted based on the PRISMA model, including articles published in the last 10 years in the PubMED, LILACS, Science Direct, Scielo, and Cochrane Central Register databases. The protocol was registered on the Prospero platform with code 482694. After the screening and selection phase, 23 articles were included, covering a total of 10,227 individuals.

It was evidenced that only 9% of the studies implemented validated scales for the definition. Based on the analysis of the definitions of difficult laparoscopic cholecystectomy proposed in various studies, it is important to highlight that conversion to open surgery (74%) and prolonged surgical time (65%) were the most frequently used criteria, followed by other parameters such as biliary tract injury (35%), bleeding (30%), and, to a lesser extent, subtotal cholecystectomy.

Although there is no unified definition of difficult cholecystectomy, elements that consistently form part of these definitions include prolonged surgical time, bile duct injury, bleeding, and conversion to open surgery. These are easily identifiable, measurable, and reproducible characteristics, which would allow for the construction of a comprehensive definition based on these.