STUDY OF PREOPERATIVE CLINICAL AND INVESTIGATIVE FACTORS PREDICTING DIFFICULT LAPAROSCOPIC CHOLECYSTECTOMY
Authors: Dr. Deepak Verma , Dr. Ratan , Dr. Nemi Chand
Number of views: 35
Background: Laparoscopic cholecystectomy is one of the most commonly performed surgical
procedure with the advantage of short hospital stay, cosmetic, less post-operative pain and early
return to work and thus ultimately cost effective. However, certain factors can make the procedure
difficult and such patients many do not enjoy benefit of laparoscopic procedure particularly longer
Aim: To determine various factors on clinical, pathological and radiological grounds to predict
difficult laparoscopic cholecystectomy.
Material and Method: 200 patients admitted in surgical ward with a diagnosis of Chronic
Calculus cholecystitis to be selected for laparoscopic cholecystectomy were subject of this study.
Age, Sex, BMI, number of previous attack, previous abdominal surgery, past history of pancreatitis
and jaundice, signs of acute cholecystitis, leucocytosis, CRP, Liver function tests, serum amylase
and lipase, GB wall thickness, presence of pericholecystic fluid , status of GB and anatomical
variation were various factors studied.
Results: Age > 50 years, male sex, BMI>30, more than 4 attacks, signs of cholecystitis,
leucocytosis > 11,000/cu mm, increased GB wall thickness, presence of pericholecystic fluid and
overdistended or contracted gall bladder are associated with difficult laparoscopic