Preoperative prediction of difficulty of Laparoscopic Cholecystectomy

Abstract

Laparoscopic cholecystectomy, one of the most commonly performed surgical procedures worldwide, is accepted as the gold standard in the treatment of symptomatic gallstones for its minimal invasiveness, less pain and early recovery. Although laparoscopic cholecystectomy has generally a low incidence of morbidity and mortality and of conversion rate to open surgery, its outcome is particularly affected by the presence and severity of inflammation, advancing patients age, male sex and greater body mass index. Sometimes Laparscopic Cholecystectomy becomes difficult. It takes longer time even with bile/stone spillage and occasionally it requires conversion to open cholecystectomy. It may be difficult to anticipate preoperatively whether this procedure is going to be easy or difficult in a particular patient. The degree of difficulties is again impossible to predict but it is important to know for better preparedness for the surgeon and explanation to patients for possibility of conversion to open. Our study aimed to determine predefined preoperative factors that predict the degree of difficulties during laparoscopic cholecystectomy (LC) so as to minimize rate of complications and conversion of laparoscopic cholecystectomy to open one that leads to improve the outcome of cholecystectomy.