medigraphic.com
ISSN 2594-1518 (Electronic)
ISSN 1405-0099 (Print)

2026, Number 3

<< Back Next >>

Cir Gen 2026; 48 (3)

Association of the Parkland grading scale with early postoperative symptoms after laparoscopic cholecystectomy: a prospective cohort study

Chalita JJA, Vázquez RMA, Chalita-MA, Rodríguez PA

Language: Spanish
References: 15
Page: 146-153
PDF size: 782.29 Kb.


ABSTRACT

Introduction: the Parkland grading scale is a tool used to classify the severity of gallbladder inflammation during laparoscopic cholecystectomy. Its application allows estimation of surgical difficulty and potential postoperative clinical outcomes. Objective: to evaluate the degree of early postoperative symptoms in patients undergoing acuscopic cholecystectomy according to the grades of the Parkland scale. Material and methods: a prospective longitudinal cohort study with blinding and interobserver agreement analysis using the Kappa index was conducted. A total of 150 patients undergoing acuscopic cholecystectomy were intraoperatively classified according to the Parkland scale between January 1 and December 31, 2022, at Hospital de las Americas. Postoperative follow-up was performed at two, 12, and 24 hours to assess nausea, vomiting, and abdominal distension. χ2 and Fisher’s exact tests were used for statistical analysis. Results: grade I was the most frequent (43.3%). Excellent interobserver agreement was observed (Kappa = 1). At two hours postoperatively, significant differences were identified in nausea, vomiting, and abdominal distension among the different grades of the Parkland scale. At 12 hours, significant differences were observed in nausea and abdominal distension, and at 24 hours only in abdominal distension. Conclusions: there is a direct relationship between the grades of the Parkland scale and early postoperative symptoms. Higher grades were associated with greater intensity and duration of symptoms, supporting the use of this scale as an intraoperative predictive tool.


REFERENCES

  1. González Villegas W, Bonilla Cháves G, GutiérrezCampos G, Vargas Aguilar K. Enfermedades dela vesícula y vías biliares: actualidad. Rev CiencSalud Integr Conoc. 2022; 6: 7-16. doi: 10.34192/cienciaysalud.v6i3.311.

  2. Angarita FA, Acuña SA, Jiménez C, Garay J, GómezD, Domínguez LC. Colecistitis calculosa aguda. UnivMed. 2010; 51: 301-319. doi: 10.11144/Javeriana.umed51-3.ccag.

  3. Escuela de Medicina, Pontificia Universidad Católicade Chile. Enfermedades de la vesícula y vías biliares[Internet]. Santiago: Pontificia Universidad Católicade Chile; [citado 2025 abr 27]. Disponible en: https://medicina.uc.cl/publicacion/enfermedades-de-lavesicula-y-vias-biliares/

  4. Saiman Y. Colelitiasis [Internet]. Manual MSDversión para profesionales. Rahway (NJ): Merck& Co., Inc.; 2026. Disponible en: https://www.msdmanuals.com/es/professional/trastornoshep%C3%A1ticos-y-biliares/trastornos-de-laves%C3%ADcula-biliar-y-los-conductos-biliares/colelitiasis?ruleredirectid=757

  5. Vargas AAL, Moreno GR, Palacio VAF, Castro MA,Castañeda Rodríguez-Cabo A, Ayala AM et al.Colecistectomía acuscópica: experiencia y resultadosen hospital de tercer nivel. Rev Mex Cir Endoscop.2011; 12: 51-53.

  6. Madni TD, Leshikar DE, Minshall CT, Nakonezny PA,Cornelius CC, Imran JB, et al. The Parkland gradingscale for cholecystitis. Am J Surg. 2018; 215: 625-630.doi: 10.1016/j.amjsurg.2017.05.017.

  7. Sugrue M, Sahebally SM, Ansaloni L, ZielinskiMD. Grading operative findings at laparoscopiccholecystectomy- a new scoring system. World JEmerg Surg. 2015; 10: 14. doi: 10.1186/s13017-015-0005-x.

  8. Arguello G, Beltran J, Cruz I, Flores J, Romero A, GarcíaB. Is the parkland grading scale related to surgicaldifficulty in laparoscopic cholecystectomy? Int J ResMed Sci. 2022; 10: 2371-235. doi: 10.18203/2320-6012.ijrms20222831.

  9. Peñafiel Moreira JD, Gómez García TG, AnchundiaGarcía FE, Vega Borja CX. Evaluación de la escalade Parkland en los resultados de colecistectomíalaparoscópica de pacientes con pancreatitis agudabiliar en el Hospital Luis Vernaza. JAH [Internet]. 2022;5. Disponible en: https://jah-journal.com/index.php/jah/article/view/132

  10. Sisa-Segovia CG, Guggiari B, Cacace K, Acosta R,Luraschi V. Aplicación de la escala de Parkland encolecistectomías videolaparoscópicas. Cir Parag[Internet]. 2022; 46: 7-11. Disponible en: http://scielo.iics.una.py/scielo.php?script=sci_arttext&pid=S2307-04202022000200007&lng=en

  11. Madni TD, Nakonezny PA, Barrios E, Imran JB,Clark AT, Taveras L, et al. Prospective validationof the Parkland Grading Scale for Cholecystitis.Am J Surg. 2019; 217: 90-97. doi: 10.1016/j.amjsurg.2018.08.005.

  12. Liu YQ, Wang C, Cai X, Zheng ZX, Bi JT. Can theparkland grading scale predict the difficulty oflaparoscopic cholecystectomy? A new approach tovalidation. BMC Surg. 2023; 23: 142. doi: 10.1186/s12893-023-02036-0.

  13. Shrestha A, Bhattarai A, Tamrakar KK, Chand M, YonjanTamang S, Adhikari S, et al. Utility of the ParklandGrading Scale to determine intraoperative challengesduring laparoscopic cholecystectomy: a validationstudy on 206 patients at an academic medical centerin Nepal. Patient Saf Surg. 2023; 17: 12. doi: 10.1186/s13037-023-00364-x.

  14. Fabara Salvador FS, Martínez Gutiérrez JA, PérezGuerron CM, Romero Zapata LC, Monserrate MaggiJO. Colecistectomía laparoscópica: beneficios y retosen el manejo de la colecistitis aguda. RECIAMUC.2024; 8: 864-881.

  15. Sevik H, Karsidag T, Tatar C. A narrative reviewof technical developments for the laparoscopiccholecystectomy. Ann Laparosc Endosc Surg. 2024;9: 14-23. doi: 10.21037/ales-23-54.




2020     |     www.medigraphic.com