Abstract

ABSTRACT:
BACKGROUND:
Laparoscopic cholecystectomy(LC) may be rendered ‘difficult’ by various problems encountered
during surgery e.g accessing the peritoneal cavity, dissecting the gall bladder … etc.
OBJECTIVE:
To identify certain preoperative clinical parameters to predict technical difficulties during (LC) .
SETTING: Surgical wards of Al-Jamhoori Teaching Hospital between October 2009 to October 2010.
METHODS:
A prospective analysis of150 patients who underwent (LC). Prospective analysis of different
preoperative data including patient's age, gender, weight, height, previous abdominal surgery and
previous attack of acute cholecystitis were done. The dependent variables (outcomes) included the
duration of operation, bleeding, difficult accessing, bile leak, difficult dissection of gall bladder, and
conversion to open cholecystectomy. Surgeons who performed the operations had operative experience
of more than 50 (LC)
RESULTS:
The difficulties were met in 57(38%) patients. The mean duration of surgery was 79·83 ± 1·30 minutes.
Factors contributed to difficult (LC) were; male gender, previous upper abdominal surgery and BMI >
35.
CONCLUSION:
Preoperative clinical patient's factors including male gender, BMI > 35 and history of previous upper
abdominal surgery are significant predictive preoperative parameters for difficult (LC). Knowledge of
these parameters preoperatively can predict difficulties during (LC).