Evaluation of Clinicopathological and Radiological Parameters in Predicting the Difficulty of Laparoscopic Cholecystectomy
4 affiliations
- 1Junior Resident, Department of General Surgery, Maharani Laxmi Bai Medical College, Jhansi, Uttar Pradesh, India
- 2Professor, Department of General Surgery, Maharani Laxmi Bai Medical College, Jhansi, Uttar Pradesh, India
- 3Associate Professor, Department of General Surgery, Maharani Laxmi Bai Medical College, Jhansi, Uttar Pradesh, India
- 4Assistant Professor, Department of General Surgery, Maharani Laxmi Bai Medical College, Jhansi, Uttar Pradesh, India
Abstract
Background: Difficult laparoscopic cholecystectomy carries prolonged operative time, conversion, and morbidity; preoperative identification of high-risk patients aids planning and counselling.
Aims/Objectives: To determine the clinical, pathological, and radiological parameters that predict difficult laparoscopic cholecystectomy and to identify independent predictors.
Methodology: This prospective observational study enrolled 100 patients undergoing elective laparoscopic cholecystectomy for symptomatic cholelithiasis. Preoperative clinical, biochemical, and ultrasonographic parameters were recorded and correlated with an operationally defined difficult procedure. Associations were assessed using the chi-square test, Fisher exact test, and independent t-test, followed by multivariable logistic regression.
Results: A difficult procedure occurred in 26 (26.0%) patients. Significant predictors were gallbladder wall thickening greater than 3 millimetres (13/26, 50.0% versus 8/74, 10.8%; odds ratio 7.82; p<0.001), positive Murphy sign (11/26, 42.3% versus 2/74, 2.7%; p<0.001), prior hospitalisation (12/26, 46.2% versus 4/74, 5.4%; p<0.001), two or more previous attacks (16/26, 61.5% versus 16/74, 21.6%; p<0.001), raised alkaline phosphatase (10/26, 38.5%; p=0.002), and leucocytosis (11/26, 42.3%; p=0.009). Wall thickening remained an independent predictor (adjusted odds ratio 4.62; p=0.021). Conversion to open surgery was required in 2 (2.0%) patients.
Conclusions: Gallbladder wall thickening, inflammatory clinical signs, and recurrent biliary disease reliably predict operative difficulty and permit preoperative risk stratification.
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BibTeX
@article{garg2026evaluation,
title = {{Evaluation of Clinicopathological and Radiological Parameters in Predicting the Difficulty of Laparoscopic Cholecystectomy}},
author = {Prabhat Garg and Albail Singh Yadav and Saurabh Purohit and Dhananjay Saxena},
journal = {International Journal of Medical Sciences and Academic Research},
year = {2026},
month = oct,
doi = {10.5281/zenodo.23635723},
url = {https://doi.org/10.5281/zenodo.23635723},
note = {CC BY},
}
RIS
TY - JOUR
TI - Evaluation of Clinicopathological and Radiological Parameters in Predicting the Difficulty of Laparoscopic Cholecystectomy
AU - Prabhat Garg
AU - Albail Singh Yadav
AU - Saurabh Purohit
AU - Dhananjay Saxena
PY - 2026
DA - 2026/10/25
JO - International Journal of Medical Sciences and Academic Research
DO - 10.5281/zenodo.23635723
UR - https://doi.org/10.5281/zenodo.23635723
AB - Background: Difficult laparoscopic cholecystectomy carries prolonged operative time, conversion, and morbidity; preoperative identification of high-risk patients aids planning and counselling. Aims/Objectives: To determine the clinical, pathological, and radiological parameters that predict difficult laparoscopic cholecystectomy and to identify independent predictors. Methodology: This prospective observational study enrolled 100 patients undergoing elective laparoscopic cholecystectomy for symptomatic cholelithiasis. Preoperative clinical, biochemical, and ultrasonographic parameters were recorded and correlated with an operationally defined difficult procedure. Associations were assessed using the chi-square test, Fisher exact test, and independent t-test, followed by multivariable logistic regression. Results: A difficult procedure occurred in 26 (26.0%) patients. Significant predictors were gallbladder wall thickening greater than 3 millimetres (13/26, 50.0% versus 8/74, 10.8%; odds ratio 7.82; p<0.001), positive Murphy sign (11/26, 42.3% versus 2/74, 2.7%; p<0.001), prior hospitalisation (12/26, 46.2% versus 4/74, 5.4%; p<0.001), two or more previous attacks (16/26, 61.5% versus 16/74, 21.6%; p<0.001), raised alkaline phosphatase (10/26, 38.5%; p=0.002), and leucocytosis (11/26, 42.3%; p=0.009). Wall thickening remained an independent predictor (adjusted odds ratio 4.62; p=0.021). Conversion to open surgery was required in 2 (2.0%) patients. Conclusions: Gallbladder wall thickening, inflammatory clinical signs, and recurrent biliary disease reliably predict operative difficulty and permit preoperative risk stratification.
SN - 2582-7197
ER -