A Cross-Sectional Study to Determine Predictive Factors for Difficult Laparoscopic Cholecystectomy Using Ultrasonographic Criteria

Abstract

Background: Laparoscopic cholecystectomy (LC) is the gold standard for the treatment of symptomatic gallstones. However, in some cases, the procedure can be technically challenging, leading to increased morbidity and longer operative times. Early prediction of difficult laparoscopic cholecystectomy (DLC) can help in better patient management. Ultrasonography is a commonly available imaging technique that can aid in predicting DLC. This study aims to identify ultrasonographic criteria predictive of difficult laparoscopic cholecystectomy.

Methods: This cross-sectional study was conducted on 150 patients diagnosed with symptomatic cholelithiasis who were scheduled for laparoscopic cholecystectomy. Preoperative ultrasonographic findings, such as gallbladder wall thickness, stone size, gallbladder volume, and the presence of pericholecystic fluid, were evaluated as potential predictive factors for DLC. The outcome of surgery, including duration and complication rate, was recorded and correlated with ultrasonographic findings.

Results: Ultrasonographic factors such as increased gallbladder wall thickness, large stone size, and the presence of pericholecystic fluid were significantly associated with longer operative time and higher complication rates, indicating a higher likelihood of a difficult laparoscopic cholecystectomy.

Conclusion: Ultrasonographic criteria, including gallbladder wall thickness, stone size, and the presence of pericholecystic fluid, can be reliable predictors of difficult laparoscopic cholecystectomy, aiding in preoperative planning and risk stratification.

Keywords: laparoscopic cholecystectomy, difficult cholecystectomy, ultrasonography, gallbladder, predictive factors.