Pre-operative prediction of difficult laparoscopic cholecystectomy from clinical, hematological and radiological parameters

Abstract

Background: The aim of study was to formulate a scoring system to predict difficult laparoscopic cholecystectomy (LC) pre-operatively; depending on the specific parameters of an individual patient.Methods: We have included 100 patients who underwent LC from July 2010 to December 2012. Conversion to open cholecystectomy in relation with age, sex, attack of acute cholecystitis, fever, abdominal tenderness, serum amylase and LDH level, status of GB and GB wall thickness, number of stone, leukocyte count and CBD diameter were assessed.Results: The most important reason for conversion was adhesions at Calot's triangle (60%), followed by contracted gall bladder (15%). The other reasons of conversion were empyema of the gall bladder (15%), stone at Hartmann's pouch (10%), bleeding during dissection (5%).Conclusions: This study will surely help the surgical fraternity in the future to plan the particular patients for appropriate mode of surgery, pre-operative preparation, patient counselling and most importantly to predict the score for the difficult interval Laparoscopic Cholecystectomy.