U. A. Chandak1, Arti Mitra2, Manish Singh3, Prashant Agrawal4, Ritesh Satardey5
BACKGROUND: Laparoscopic cholecystectomy is the standard of care for the treatment of symptomatic gallbladder disease and one of the most common procedures being performed by the general surgeons all over the world. With more and more endeavors being made in the field of laparoscopy, more and more complicated cases which were relatively contraindicated a few years ago, are now being tackled laparoscopically.
AIM: Aims of this study is assessment of risk factors, diagnostic approach and management of cases undergoing difficult cholecystectomies on basis of clinical, USG, preoperative, intra operative findings, duration of surgery, rate of conversion, post op complications and duration of stay in hospital.
MATERIAL & METHODS: Prospective study done from June 2012 to Nov. 2014, 192 cases undergoing laproscopic cholecystectomy included in study at tertiary care hospital
RESULT: Cholecystitis or pancreatitis and thickened GB wall, PREOP ERCP are found to be significantly associated with increased risk of conversion. Obesity (BMI≥30 kg/m2 ) was significantly associated with difficulty in access to the peritoneal cavity. Various factors.
CONCLUSION: clinical factors like male sex, previous acute cholecystitis or pancreatitis and ultrasonographic finding of gall bladder wall thickness ≥4 mm can help to predict difficult laparoscopic cholecystectomy and likelihood of conversion of laparoscopic cholecystectomy to open cholecystectomy.