Assessment of the difficulties in laparoscopic cholecystectomy among patients at Baghdad province.

Background: Laparoscopic surgery for gallbladder cholecystectomy has become the typical procedure for symptomatic gallbladder stone diseases treatment as a type of minimal invasiveness surgery associated with less pain and early recovery as there is minimal trauma of access without shrinking the exposure of operative field. The current study aimed to assess factors associated with difficult LC.

Methodology: A cross sectional study was conducted at medical city complex (Baghdad Teaching Hospital) from October 2015 to October 2016, in which all patients that were admitted for LC were examined preoperatively, underwent LC and followed postoperatively to study factors associated with difficult LC. All LC were operated by qualified senior surgeons and supervised by well-trained resident doctors. A pre-operative score system parameters were obtained from history, clinical examination and investigation findings.

Results: Laparoscopic cholecystectomy was performed for 100 patients, 78% were females and 49% were among 40-59 years of age. The preoperative scoring revealed that in 58% of the patients the score indicate difficulty, and very difficult in only 7% of the patients. Difficult and very difficult operations were significantly associated with high difficult scoring preoperatively, gender, BMI and cause of admission.

Conclusion: High difficult scoring preoperatively, gender, BMI and cause of admission can be used as predictors for difficult LC.