Nassar operative grade and ultrasonography prediction for difficult laparoscopic cholecystectomy

Background: ‘Gold standard’ for symptomatic cholelithiasis is laparoscopic cholecystectomy (LC) with advantagesof minimal access surgery, early return to activity cosmetic scar. However, this may not always holdtrue in all cases. Conversion open procedure challenging circumstances would be better interest of the patient even after learning curve surgeon has surpassed several years. Methods: Forty patients undergoing gall stone disease without any acute episode past six weeks were investigated. All cases evaluated clinical examinations, biochemical parameters and preoperative ultrasonography done a day prior prediction difficult LC. correlated USG Nassar per operative grade (1-4 5) analyzed method situations. Complications associated 30 surgical interventions also recorded. Results: Difficult was anticipated 20 cases, grading difficulty (Grade-3, 4 predicted 13 cases; latter conversion methods. p<0.05 considered significant. There no complications nor required during days interval.Conclusions: Per likelihood helps guiding situation safely proceed complete either by laparoscope or patient.