Background: Gallstone disease is among the most common gastrointestinal illness requiring hospitalization. Laparoscopic cholecystectomy is
now the preferred approach to its treatment. When performing laparoscopic cholecystectomy, the surgeon should have the low threshold for open
conversion in case of difculty. The aim of the study was Pre-operative prediction of difcult laparoscopic cholecystectomy using clinical,
ultrasonographic and intraoperative parameters.
Methods:This study was done on 200 patients presenting with symptomatic cholelithiasis who underwent laparoscopic cholecystectomy. A
prospective analysis of parameters including the patient demographics, laboratory values, radiologic data and intraoperative parameters was
performed.
Results: The factors which were considered a difculty parameter were males, age>60years, preoperative ERCP, rised amylase, sonographic
features of contracted or distended gallbladder and pericholecystic collection. Intraoperative parameters were adhesions around gallbladder,
contracted or distended gallbladder inamed gallbladder.
Conclusions: The above mentioned factors must be adequately studied and the surgeon and the patient should be prepared for difcult
laparoscopic cholecystectomy.