Ten-point Strategy for Safe Laparoscopic Cholecystectomy: A Prospective Study

Abstract

Aims/objectives: To devise a 10-point strategy for performing safe laparoscopic cholecystectomy (LC), share experience of 8,000 patients without any conversion to open procedure by adopting the strategy, and assess its effectiveness. Materials and methods: A total of 8,000 patients were prospectively analyzed during 2007 to 2017. A point was assigned to a specific finding intraoperatively. Patients were divided into three groups based on the points. Anatomical variations, time of surgery, intraoperative/postoperative complications were plotted for three groups, and statistical significance was calculated. Results: In this study, 63.5% of patients were female. No case of conversion to open cholecystectomy (OC) was found. The youngest and oldest patients were 2 and 109 years old, respectively. Mortality, negligible morbidity, or significant complications were not observed. Group I (1–4 points) had high-risk patients, and lowest safety, and group III (8–10 points) had low-risk patients, and highest safety, and group II (5–7 points) had with equivocal numbers. Conclusion: Laparoscopic cholecystectomy was performed keeping these 10 points in mind with patience and precautions. Chances of conversion to open surgery can be reduced to zero, with minimal complications. The study suggests that in case of difficult anatomy, go gentle and slow to safeguard from injuries.