Abstract

Introduction: Laparoscopic cholecystectomy is one of the most common laparoscopic procedures being performed by general surgeons all over the world. Preoperative prediction of the risk of conversion or difficulty of operation is an important aspect of planning laparoscopic surgery. The purpose of our retrospective study was to analyse various risk factors and to predict difficulty preoperatively by the use of a scoring system.

Materials: This retrospective study was conducted in the Department of General Surgery, NRI Medical College, Chinakakani. The parameters considered in the preoperative scoring method were age, sex, previous abdominal surgery, diabetes mellitus, history of pain in the right hypochondrium, history of fever, thickness of gall bladder wall, diameter of the common bile duct, size of the gall stone, pericholecystic collection, total leucocyte count, serum bilirubin, transaminases, ALP/GGT levels. A total of 51 patients were included in the study

Results: Conversion rate from laparoscopic to open cholecystectomy was found to be 9.8%. We found sensitivity and specificity of this preoperative scoring method to be 80% and 97.8% respectively.

Conclusion: With the help of accurate prediction, high risk patient may be counseled before the surgery regarding the probability of conversion. On the other hand, surgeons could be prepared for the possible complications that might arise and take necessary precautions in these high risk patients.

Keywords: laparoscopic cholecystectomy, open cholecystectomy, conversion, prediction