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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).

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