Utilization of the modified Kama scoring system for predicting bail-out cholecystectomy: a valuable tool in the era of rising laparoscopic surgery prevalence.
Surg Today
; 2024 May 12.
Article
en En
| MEDLINE
| ID: mdl-38734830
ABSTRACT
PURPOSE:
Recently, bail-out cholecystectomy (BOC) during laparoscopic cholecystectomy to avoid severe complications, such as vasculobiliary injury, has become widely used and increased in prevalence. However, current predictive factors or scoring systems are insufficient. Therefore, in this study, we aimed to test the validity of existing scoring systems and determine a suitable cutoff value for predicting BOC.METHODS:
We retrospectively assessed 305 patients who underwent laparoscopic cholecystectomy and divided them into a total cholecystectomy group (n = 265) and a BOC group (n = 40). Preoperative and operative findings were collected, and cutoff values for the existing scoring systems (Kama's and Nassar's) were modified using a prospectively maintained database.RESULTS:
The BOC rate was 13% with no severe complications. A logistic regression analysis revealed that the Kama's score (odds ratio, 0.93; 95% confidence interval 0.91-0.96; P < 0.01) was an independent predictor of BOC. A cutoff value of 6.5 points gave an area under the curve of 0.81, with a sensitivity of 87% and a specificity of 67%.CONCLUSIONS:
Kama's difficulty scoring system with a modified cutoff value (6.5 points) is effective for predicting BOC.
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Base de datos:
MEDLINE
Idioma:
En
Revista:
Surg Today
Año:
2024
Tipo del documento:
Article
País de afiliación:
Japón