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Intraoperative Predictors of Laparoscopic Cholecystectomy
Table 2: Proposed AMU scoring system of predicting difficult LC
GB condition Normal 0 No adhesion 0
Distended 1 Easily separable/mild adhesion 0
Edematous and inflamed 1 Adhesions Moderate adhesion requiring energy 1
Contracted and inflamed 1 Only intra-abdominal adhesion 4
Congested and inflamed 2 Intra-abdominal and GB adhesions 5
Contracted and congested 3 Very severe adhesion/buried GB 5
Empyema 5 Normal/clear 0
Intraoperative pericholecystic fluid Absent 0 Partially obscure 0
Cystic duct abnormality 2
Present 5 Calot’s triangle Partial obscure with cystic duct/
Hartman pouch status Normal/no stone 0 status vessel abnormality 5
Vessel abnormality 5
Impacted stone 5 Fully obscure frozen 5
AMU: Aligarh Muslim University
Score 0–5: Easy
Score 6 and above: Difficult

conclusIon
From this study, we concluded a scoring system based on an
intraoperative procedure that can identify difficult procedures
so as to save time and any untoward complications. Features like
intraperitoneal adhesions, structural anomalies or distortions
distended or contracted GB, and the frozen Calot’s triangle are
signs that are associated with difficulties during the surgery. These
classification systems would be of great help in improving the
outcomes of LC.

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