VALIDATION OF G10 CLASSIFICATION IN LAPAROSCOPIC CHOLECYSTECTOMY FOR THE PREDICTION OF OPERATIVE DIFFICULTIES: AN OBSERVATIONAL STUDY

Abstract

Introduction: Laparoscopic cholecystectomy which is the gold standard of management of gall bladder pathologies has variability in terms of conversion to open procedure and operative difficulties according to the intraoperative findings.The G10 scoring system is used to predict the diificulty and outcome of surgery. Aims And Objectives: The study aimed at intraoperative assessment of gall bladder and its anatomy and surgical difficulty in laparoscopic cholecystectomy. Objective is to correlate the following factors :conversion to open procedure, surgical complication, operating time, hospital stay and readmission. Materials And Methods: All patients undergoing Laparoscopic cholecystectomy in College of Medicine and JNM Hospital, six months from the approval of Institutional Ethical Committee were used as samples. Result: 13% of difficult and 75% of extremely difficult cases were converted to open.In difficult level, 4.3% had bile duct injury, pericholecystic abcess formation and readmission whereas in extreme difficult level, 25% had bile duct injury, abcess formation and readmission. Conclusion: The more the G10 score, the more the difficulty level and there is more conversions and complications. Association of conversion,readmission and complications with degree of difficulty is statistically significant i.e. G10 classification remains a valid indicator for operative difficulties.