Preoperative prediction of the difficulty of laparoscopic cholecystectomy

Introduction: Preoperative complexity estimation helps deciding whether to proceed with a minimally invasive approach or perform an open procedure. Laparoscopic cholecystectomy outcome is particularly affected by the presence and severity of inflammation, advancing age, male sex and greater BMI. Objective: To study Preoperative prediction of difficult laparoscopic cholecystectomy. Patients and Methods: A total of 102 patients were enrolled to this study who were symptomatic, positive findings on clinical examination and ultrasound abdomen. The triad of clinical examination, laboratory data and ultrasound study was performed for all patients. The primary end point of the study was operative outcome and the second end point was morbidity related to surgery. Results: The operative outcome was represented as operative bleeding and conversion to open surgery while the postoperative outcome was biliary leakage and port site infection. The total score for each patient with conversion to open surgery or with postoperative biliary leakage was between 6-10 points indicating difficult surgical approach according to the scoring system. Conclusion: Preoperative prediction of risk factors of conversion or difficult laparoscopic cholecystectomy is an important point for operative planning and the high risk patients may be informed accordingly.