Study of the Pre-operative and Intra-operative Factors for Predicting Difficult Laparoscopic Cholecystectomy

Laparoscopic Cholecystectomy is the most common   sometimes ‘difficult’ laparoscopic surgery being performed by general surgeons. Various preoperative   introperative factors can help in determining the laparoscopic cholecystectomy

Total 150 patients of cholelithiasis who underwent Laparoscopic Cholecystectomy were included in this study. Pre-operative clinical features, USG findings   intra-operative findings were studied. Patients with features of obstructive jaundice, raised alkaline phosphatase, dilated common bile duct or with calculus, suspected malignant gall bladder disease, medically unfit for laparoscopic surgery or those unwilling to take part were excluded from study.

Following factors were found significant-BMI > 30 kg/m², palpable gall bladder, size of calculi more than 10mm, adhesions in gall bladder area, frozen calot's triangle, significant intra-operative bleeding, difficult GB bed dissection, intra-operative bile/stone spillage, difficult gall bladder extraction because of thick wall.