Abstract
Laparoscopic Cholecystectomy has become the standard of care for Gall Stone Disease. There are numerous studies and scoring system which considers the pre-operative factors for conversion to open cholecystectomy but there was no scoring system which considers intra operative findings. The objective of this study was to outline the scoring system based on intra operative findings to predict the conversion of laparoscopic cholecystectomy to open cholecystectomy. This prospective study was carried out on 158 patients who underwent cholecystectomy. Surgery in all patients were started with laparoscopic cholecystectomy and based on multiple factors the surgery was completed as open or laparoscopic cholecystectomy. Based on the intra operative findings the patients were divided into easy, moderate, very difficult and extreme. The patients with severe and extreme scoring had highest number of conversions to open cholecystectomy and those patients who had total score of less than 5 had negligible conversion to open cholecystectomy. This paper reports the scoring system which considers the intra operative findings during laparoscopic cholecystectomy. Based on this scoring system it can be predicted weather conversion to open cholecystectomy is required or not.
Highlights
Laparoscopic Cholecystectomy has become increasingly common since 1980 and has replaced open cholecystectomy as the standard of care [1, 2]
The scoring system is based on severity of cholecystitis and grades of potential difficulty with total score ranging from 1 to 10
The score of 2-4 was considered moderate difficulty, 5-7 severe difficulty and a score of 8 or more was considered extremely difficult with highest rate of conversion to open cholecystectomy
Summary
Laparoscopic Cholecystectomy has become increasingly common since 1980 and has replaced open cholecystectomy as the standard of care [1, 2]. The laparoscopic approach causes less mortality and morbidity compared to conventional cholecystectomy. It offers the advantage of being minimal invasive, less hospital stays, less post-operative pain and early recovery [3,4,5]. Management of cholelithiasis has seen a shift from conventional open cholecystectomy to laparoscopic cholecystectomy [6,7,8]. It has been seen that surgeons face difficulty during laparoscopic surgery when there are dense adhesions at Calot’s triangle, fibrotic or contracted bladder [12]. Conversion to open cholecystectomy would always be considered as the part of safe surgical practise but a detailed understanding of the factors leading to conversion is important
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
