IJSR International Journal of Scientific Research 2277 - 8179 Indian Society for Health and Advanced Research ijsr-9-6-25602 Original Research Paper TO IDENTIFY THE PREDICTORS OF DIFFICULTY IN LAPAROSCOPIC CHOLECYSTECTOMY Mohit Goyal Dr. June 2020 9 6 01 02 ABSTRACT

Introduction– Gall stone disease is a major problem in our society. Since the introduction of laparoscopic cholecystectomy in 1987, it has dramatically replaced conventional open cholecystectomy. In spite of one of the most commonly performed surgery, Laparoscopic cholecystectomy can sometimes throw major challenges in front of surgeon. Prediction of difficulty will help in better pre–operative planning , thus reducing chances of adverse events. Purpose of this study is to identify the predictive factors for difficult laparoscopic cholecystectomy. Material & methods– This was a prospective study of 100 patients between Dec.2018 to Feb.2020 who underwent laparoscopic cholecystectomy at Government Doon medical college, Dehradun. Details of patients were recorded including history, clinical examination and investigations done. A detailed proforma was used to record these particulars of the patients . Results– Total of 100 patients included in our study, majority of the patients were in the age group of 31–40 years (30 out of 50). Out of 100 patients, 16 had a history of acute cholecystitis and all encountered difficulty during surgery. Out of 16 patients with H/O acute cholecystitis , 6 patients had 1 episode, 2 patients had 2 episodes and 8 patients with > 2 episodes of acute cholecystitis.. Only 4 patients had H/O previous abdominal surgery. 14 patients had deranged LFT. Thickened GB wall thickness >3mm found in 10 patients. Conclusion– Difficulty in laparoscopic cholecystectomy can be predicted on the basis of history and clinical examination. With the help of accurate prediction, high risk patients can also be informed beforehand, and they may have a chance to make arrangements. Surgeons also may have to schedule the time and team for the operation appropriately