Page 38 - World Journal of Laparoscopic Surgery

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)