Grading System Based on Intra Operative Findings at Laparoscopic Cholecystectomy

Abstract

Laparoscopic Cholecystectomy has become the standard of care for Gall Stone Disease. There are numerous studies and scoring system which considers the pre-operative factors for conversion to open cholecystectomy but there was no scoring system which considers intra operative findings. The objective of this study was to outline the scoring system based on intra operative findings to predict the conversion of laparoscopic cholecystectomy to open cholecystectomy. This prospective study was carried out on 158 patients who underwent cholecystectomy. Surgery in all patients were started with laparoscopic cholecystectomy and based on multiple factors the surgery was completed as open or laparoscopic cholecystectomy. Based on the intra operative findings the patients were divided into easy, moderate, very difficult and extreme. The patients with severe and extreme scoring had highest number of conversions to open cholecystectomy and those patients who had total score of less than 5 had negligible conversion to open cholecystectomy. This paper reports the scoring system which considers the intra operative findings during laparoscopic cholecystectomy. Based on this scoring system it can be predicted weather conversion to open cholecystectomy is required or not.