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Preoperative Scoring System to Predict Difficult LC
























            Fig. 3: Column diagram showing clinical examination findings   Fig. 5: Pie diagram showing preoperative score grading distribution
            distribution
                                                               Table 6: Operative findings distribution (total number of patients = 66)
            Table 4: Sonologic findings distribution (total number of patients = 66)
                                                                                                Count         %
                                                 Count    %
                                                                Placement of drain    No          55         83.3
             Wall thickness        Thin <4 mm     36     54.5
                                                                                      Yes         11         16.7
                                   Thick ≥4 mm    30     45.5
             Pericholecystic collection  No       53     80.3
                                   Yes            13     19.7
             Impacted stone        No             52     78.8
                                   Yes            14     21.2

















                                                               Fig. 6: Pie diagram showing placement of drain distribution
                                                               had bleeding from cystic artery, 3 (4.5%) had thickly adherent
                                                               gallbladder, 2 (3%) had spilled gallstones, 1 (1.5%) had bleeding
                                                               from abdominal wall (port) and 1 (1.5%) had bleeding from tissues
                                                               adjacent to the gallbladder (Tables 7 and 8, Figs 7 and 8).
            Fig. 4: Bar diagram showing sonologic findings distribution  Operative outcome was easy in 39 (59.1%), difficult in 20 (30.3%),
                                                               and very difficult in 7 (10.6%) subjects (Table 9, Fig. 9).
            Table 5: Preoperative scoring distribution (total number of patients = 66)  In total, 39 patients out of 66 were preoperatively predicted
                                                               to have an easy cholecystectomy depending on their scores. In
                                               Count      %    total, 36 (92.3%) patients in whom easy procedure was predicted
             Preoperative score   Easy          39       59.1  preoperatively had an easy cholecystectomy. Only 3 (15%) had
             grading            Difficult       23       34.8  a difficult procedure in spite of being predicted otherwise, no
                                                               patients with an easy grading underwent a very difficult procedure
                                Very difficult    4       6.1
                                                               (Table 10, Fig. 10).
                                                                  In total, 23 patients out of 66 were preoperatively predicted
               Out of 66 patients, 52 (78.8%) had no intraoperative   to have a difficult cholecystectomy depending on their scores.
            complications, while 14 (21.2%) had intraoperative complications,   17 (85%) of patients in whom difficult procedure was predicted
            4 (6.1%) had iatrogenic perforation of the gallbladder, 3 (4.5%)   preoperatively had an difficult cholecystectomy. 3 (7.5%) had an

            134   World Journal of Laparoscopic Surgery, Volume 15 Issue 2 (May–August 2022)
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