Predicting difficult Laparoscopic Cholecystectomy based on clinico radiological parameters

Laparoscopic cholecystectomy is now considered to be gold standard operation for cholelithiasis. Preoperative prediction of difficult laparoscopic cholecystectomy can help in better preparation to tackle intraoperative difficulties and assessing chances of conversion to open procedure. The aim is to predict difficult laparoscopic cholecystectomies by clinical and radiological assessment. Patients reporting to the Surgery dept. within study duration Jan. 2016 to Dec.2016. Pre-operative clinical and ultrasonographic criteria were considered and compared with intraoperative difficulty encountered. Out of 50 patients, 3 required conversion to open cholecystectomy. Factors that were significant in predicting difficult laparoscopic cholecystectomy were attack of cholecystitis in last 15 days from surgery, duration of attacks of cholecystitis for more than 6 months, history of fever during attacks of cholecystitis, positive Murphy's sign at the time of presentation, gall bladder wall thickness >3mm. Difficult laparoscopic cholecystectomy can be predicted based on clinical and ultrasonographic findings.