A prospective study of preoperative scoring system in predicting difficulty in elective laparoscopic cholecystectomy

Abstract

Background: Laparoscopic cholecystectomy since its discovery in 1987, has dramatically replaced conventional open cholecystectomy and rapidly became the gold standard for routine gall bladder removal. Today more than 80% of cholecystectomies are carried out laparoscopically. Laparoscopic cholecystectomy although safe and effective, yet poses many difficulties like unclear anatomy, and frozen calots. If risk factors could be reliably identified preoperatively, these factors would aid surgeons in preoperative patient counselling, informed consent, and operative strategy. Methods: This study conducted over the span of 2.5 years on 66 patients underwent elective laparoscopic cholecystectomy was done to identify risk factors preoperatively and their association with intraoperative difficulty. Results: Preoperative factors like acute cholecystitis in the past, gall bladder wall thickness and previous history of upper abdominal procedure were fund to be directly related to intraoperative difficulty and laparoscopic to open conversion. Conclusions: Preoperatively with the help this scoring system we can predict difficulty in laparoscopic cholecystectomy.