Preoperative prediction of degree of difficulty in laparoscopic cholecystectomy

Abstract

Objective To explore the methods and values of preoperative prediction of degree of difficulty in laparoscopic cholecystectomy.Methods The data on 56 patients undergoing laparoscopic cholecystectomy were retrospectively analyzed.All the patients received ultrasonography preoperatively.The criteria for degree of difficulty of the procedure were determined.According to the criteria,the patients were divided into easy procedure group ( 16 patients ) and difficult procedure group ( 40 patients ).The predicted results were compared with the actual results.Results The procedure was successfully performed on 52 of the 56 patients,and the rest 4 had to undergo laparotomy.The procedure was determined as difficulty in 40 patients intraoperatively,which had no significant differences with preoperative prediction ( P ＞ 0.05 ).Age,body mass index,history of abdominal surgery,and amount of onset were related to degree of surgical difficulty ( P＜ 0.05 ).Gallbladder wall thickening,stone stuck in the gallbladder neck,and gallbladder with stones type were the major factors for the difficulty in the procedure.Conclusions Ultrasonic examination has a predictive value of degree of difficulty in laparoscopic cholecystectomy but should combine with age,body mass index,history of abdominal surgery,amount of onset,and length of disease course. Key words: Laparoscopy; Cholecystectomy; Preoperative difficulty; Prediction; Ultrasound