Predicting difficulties during laparoscopic cholecystectomy by preoperative ultrasound.

ABSTRACT

BACKGROUND: The aim of this study was to determine whether the preoperative USG finding can predict the risk of conversion or difficulty during the laparoscopic cholecystectomy. MATERIALS AND METHODS: 200 patients undergoing Laparoscopic cholecystectomy at Kathmandu Medical College Teaching Hospital were included. Sonographic parameters like size of gall bladder, wall thickness, distance between hepaticoduodenal ligament and Hartmann's pouch and the size of stone were taken into consideration and difficulties in terms of adhesions around gall bladder, anatomy of calot's triangle and difficulty in peeling off gall bladder from the bed and retrieval were analyzed. RESULT: In 8 of 200 patients (4%), LC was converted to open procedure. In univariate analysis all the sonographic parameters we had included in this study were statically significant (p value <0.05). CONCLUSION: Preoperative sonographic signs can predict the difficulty in laparoscopic cholecystectomy.