Predicting Difficulty in Laparoscopic Cholecystectomy Based on Clinical, Pathological, and Radiological Assessment

Abstract

Cholelithiasis is very common problem affecting humans. Laparoscopic cholecystectomy (LC) has become gold standard for the management of symptomatic cholelithiasis [2]. Approximately 2% to 14% of patients may require conversion to open surgery for various factors and complications [2,4]. It would be very useful if there is established criteria to know the chances or risk of conversion to open surgery preoperatively. This study is to predict difficult laparoscopic cholecystectomy by clinical, pathological, and radiological assessment. Methodology: In this multi-center prospective study all patients require surgery in the form of cholecystectomy for reasons like acute and chronic cholecystitis. Sixty patients who underwent laparoscopic cholecystectomy between July 2020 and June 2021 met the inclusion criteria. Findings during surgery were divided into categories like easy, difficult, and very difficult laparoscopic cholecystectomy based on operative parameters like total time for surgery, injury to cystic duct or artery, spillage of stones of gallbladder, frozen Callot’s Triangle, and convert to open surgery. Results: Patients included in the study were divided into three groups, easy, difficult, and very difficult, in each parameter taken into account for surgery. All patients of the very difficult group were converted to open surgery eventually. Mean conversion rate in our study was 6.7%.