Intra-Operative Surprise of Pre-Operative Difficult or Not Laparoscopic Cholecystectomy

Laparoscopic cholecystectomy (LC), one of the most commonly performed surgical procedures worldwide, is accepted as the gold standard in the treatment of symptomatic gallstones for its minimal invasiveness, less pain and early recovery. Sometimes Laparoscopic Cholecystectomy becomes difficult. It takes longer time even with bile/stone spillage and occasionally it requires conversion to open cholecystectomy. Aim of this work is to evaluate the pre-operative difficult or not laparoscopic cholecystectomy to intra operative surprise according to potential factors putting pre-operative. This is a prospective cohort study involved 100 patients admitted with calcular Gallbladder, arranged for laparoscopic cholecystectomy divided into two groups: Group A: Included 50 cases diagnosed pre-operative easy. Group B: Included 50 cases diagnosed pre-operative difficult. Results: 50 cases of group A 35 cases were easy intra-operative, and 15 cases were difficult. 50 cases of group B 9 cases were easy intra-operative, and 41 cases were difficult. In this study we found that age, sex and ultrasonographic data was significant predictive factors for assessment preoperatively. we can report that obese patient who over fifty with history of previous upper abdominal surgery and ultrasonographic picture showed thick-walled GB and pericholecystic collection had high risk of conversion.