Publication:

Pre-operative prediction of difficult laparoscopic cholecystectomy

Background Laparoscopic cholecystectomy has become the gold standard in the treatment of cholelithiasis and is replacing open cholecystectomy. The rate of conversion from laparoscopic cholecystectomy to open cholecystectomy is 5 to 10%. Hence it is necessary to study the predictive factors for difficult laparoscopic cholecystectomy.

Methods All patients are subjected to ultrasonographic evaluation. The patients confirmed by USG examination are evaluated with following factors: age, sex, BMI, h/o previous hospitalization, h/o previous abdominal surgeries, h/o acute cholecystitis / pancreatitis. Sonographic findings: GB wall thickness (>/ 32.5, history of cholecystitis, previous abdominal surgery, GB wall thickness>3mm, pericholecystic collection, multiple stones and liver fibrosis were significant predictors of difficult laparoscopic cholecystectomy.

Conclusions In about 5 to 10% of the cases of laparoscopic cholecystectomy, conversion to open cholecystectomy may be needed for safe removal of gallbladder. Therefore it is necessary to analyse the risk factors that predict difficult laparoscopic cholecystectomy.