Assessment of Pre - Operative Outcome with Intra - Operative Findings in Laparoscopic Cholecystectomy

Background andObjectives: Cholelithiasis is a common disease throughout the world and if untreated it may lead to various complications. Laparoscopic cholecystectomy is the current gold standard for the treatment and it can be difficult depending upon the severity. There are numerous preoperative scoring systems proposing preoperative parameters reported for difficult cholecystectomy. However, there is no operative classification for laparoscopic surgery. The present study was aimed to assess the various preoperative predictors (history/ clinical/ imaging) and develop a scoring method for difficult laparoscopic cholecystectomy with a secondary objective of correlating preoperative predictive factors with intraoperative difficulty in lap cholecystectomy. Methods: 82 patientsbetween age 18 - 60 years with acute and chronic calculous cholecystitis who required cholecystectomy were included in this study. A preoperative score was given to all the patientsbased on scoring system employed by Gupta et al. and intraoperative assessment was compared with preoperative predictive score. Results: In 91.5% cases there was a correlation between pre - operative grading and operative time gradingand only 8.5% cases did not match. Conclusion: The observation of the present study suggests that the pre - operative scoring system employed in the study turned out to be a reliable and beneficial tool in predicting the difficulty of laparoscopic cholecystectomy.