Abstract:

Laparoscopic cholecystectomy (LC) is the preferred surgical approach for treating gallstone disease; however, there are cases that pose significant challenges, often leading to a switch to open surgery. This study aims to identify preoperative indicators that suggest a difficult laparoscopic cholecystectomy (LC), focusing on demographic factors, inflammatory markers, and intraoperative challenges. A prospective study was performed on patients diagnosed with acute or chronic cholecystitis, examining factors such as gender, age, diabetes mellitu), CRP, ESR, and TC. The findings revealed a strong association between male gender, older age, and diabetes mellitus with surgical complications (p = 0.001). CRP, ESR, and TLC were significantly linked to intraoperative challenges and the need for conversion to open surgery. The severity grade of the Tokyo Guidelines (TG-13) was substantially associated with surgical difficulty (p = 0.001). These findings points out the significance of preoperative evaluation in recognising high-risk patients, facilitating enhanced surgical planning and improved patient outcomes. Nevertheless, constraints such as a single-center design and retrospective data collecting require more multi-center prospective research to improve predictive accuracy and investigate sophisticated imaging and biochemical indicators for enhanced risk stratification.

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