The aim of this study is to determine the predictive factors for difficult laparoscopic cholecystectomy
and to evaluate the effectiveness of scoring system to predict difficult cholecystectomy
Where facilities and experience are available, laparoscopic cholecystectomy
should be considered because of the advantages the patient and the surgeon get out of it like short operating times, short hospital stay, faster recuperation, less post-operative pain, better cosmesis and early return to work6.
should be performed during index hospitalization or as soon as possible within 30 days of mild biliary pancreatitis to minimize risk of recurrent biliary events," said Dr.
have found 46 (0.32%) patients with GBC out of 14.369 cholecystectomy
specimens, of which only 2 patients with stages Tis and T1a did not show suspicious lesions on preoperative and intraoperative findings (2).
Inclusion criteria comprised of all patients undergoing elective laparoscopic cholecystectomy
including both genders.
Based on the combined experience of the Department of Surgery, Sestre milosrdnice University Hospital Centre, our current practice includes minimum two postoperative days after laparoscopic cholecystectomy
. While some surgeons often discharge their patients after 24 hours, most tend to respect the Department policy of 48 postoperative hours or more.
In univariate analysis, depth of invasion of cancer (T stage), age, hepatic invasion, tumor location, extent of liver resection, and time from cholecystectomy
to referral for re-resection were identified as significant prognostic factors.
Machado and Chopra (6) examined 26 patients with SIT and suggested that laparoscopic cholecystectomy
can be safely performed in these patients.
Patients with suspected or proven common bile duct stones were referred to a tertiary centre for further investigation and were returned for elective cholecystectomy
once the common bile duct (CBD) was clear of stones.
Nowadays, LC is the standard procedure for the treatment of symptomatic GB stone, although few require conversion to open cholecystectomy
. [6,8] On the basis of radiological findings, surgeons can select the cases appropriate for their skills aiming at reducing complications and minimizing the waste of operating time available.
A keyword search of operative reports was performed using the following terms: ERCP, sphincterotomy, laparoscopic gastrostomy, laparoscopic gastrotomy, laparoscopic cholecystectomy
, and cholangiography.
Between 1st January 2014 and 31st December 2016, 1553 patients underwent a laparoscopic cholecystectomy
at Zuyderland Medical Center, Heerlen and Sittard, the Netherlands.