Prediction of Difficulty of Laparoscopic Cholecystectomy by Preoperative Ultrasonography: A Randomized Control Trial

Abstract

The aim of this study was to determine whether the preoperative USG finding can predict the difficulty during the laparoscopic cholecystectomy and its conversion. 500 patients undergoing Laparoscopic cholecystectomy at Sawai Mansingh Medical College and attached Hospital were included. Sonographic parameters like Gall Bladder wall thickness, antero posterior diameter of Gall Bladder in fasting state, impacted gall stone, CBD diameter were taken into consideration and difficulties in terms of time taken for surgery, cystic duct injury; cystic artery injury and lead to conversion were analyzed. Of the 400 cases, 24 (6.0%) were converted to open procedure. Of the 144 (36%) cases predicted to be difficult, 116 (29%) were technically difficult, of which 18 (4.5%) were converted to open procedure. Of the 256 (64%) cases predicted to be easy on ultrasonography, 19 (4.75%) were found to be difficult on surgery, of which only 6 (1.5%) had to be converted to open procedure. In univariate analysis all the sonographic parameters we had included in this study were statically significant (p value lt;0.05). This study concluded that Preoperative sonographic signs can predict the difficulty in laparoscopic cholecystectomy.