European Journal of Cardiovascular Medicine

Background: Preoperative prediction of risk factors helps in assessing the intraoperative difficulties. Various scoring systems are available to predict the intraoperative difficulties in laparoscopic cholecystectomy. However, there is the need to find a consistent and reliable scoring and predictive system. The present study was undertaken to assess preoperative scoring system in determination of intraoperative difficult laparoscopic cholecystectomy (LC). Material and methods: The prospective observational study performed on 50 patients undergoing elective LC. All the patients were assessed and data regarding the previous history, clinical examinations, and USG findings were recorded. Preoperatively patients were assessed according to Randhawa and Pujahari scoring system. Whereas, intraoperatively, based on duration of surgery.m Results: Preoperative score suggested difficult and very difficult LC in 36% and 2% of patients respectively while intraoperatively 8% of patients had difficult and very difficult LC respectively. The sensitivity, specificity, and predictive value at the preoperative score of 5 was found to be 90%, 72.7%, and 96.7% respectively. Intraoperative difficult LC was found to be significantly associated with the previous history of hospitalization (P=0.021), palpable GB (P=0.003), wall thickness >4mm (P=0.000), pericholecystic collection (P=0.000), contracted GB (P=0.000), post ERCP (P=0.000), deranged LFT (P=0.000), and WBCs >11000 (P=0.000). Conclusion: Study finds the evaluated scoring system, reliable and useful for predicting difficulty in laparoscopic cholecystectomy.