Predicting Difficulty in Laparoscopic Cholecystectomy: A Prospective Observational Study

Introduction: Laparoscopic cholecystectomy (LC) is the gold standard for treating symptomatic gallstone disease. However, some cases present challenges, leading to conversions to open cholecystectomy. Identifying predictive factors for difficult LC can improve surgical planning and patient outcomes. Methodology: A prospective observational study was conducted at a tertiary care center in Raipur, Chhattisgarh. Patients undergoing LC were evaluated using the Randhawa and Pujahari scoring system, incorporating clinical and sonographic parameters. Intraoperative findings, including operative time and conversion rates, were recorded. Results: A total of 75 patients were included. Gallbladder wall thickness >4 mm and the overall Randhawa and Pujahari scores were predictors of difficult LC. Patients with these factors had a higher conversion to open cholecystectomy. Conclusion: The Randhawa and Pujahari scoring system is a valuable tool for the preoperative risk stratification of LC. Identifying patients at risk for difficult surgery can aid in surgical planning, counseling patients, and optimizing resource allocation.