Grading of Operative Findings at Laparoscopic Cholecystectomy a New Scoring System.

Background: Laparoscopic cholecystectomy is the gold standard for treating symptomatic gallstone disease, yet the procedure faces challenges, including the risk of conversion to open surgery. A standardized method for grading operative findings could enhance surgical planning and outcomes. Methods: A new scoring system was developed and validated in a descriptive cross-sectional study at a rural hospital, involving 106 patients undergoing laparoscopic cholecystectomy. Factors such as gallbladder inflammation, adhesions, wall thickness, and visibility of anatomical landmarks were graded to assess operative difficulty. Results: The study identified significant associations between operative difficulty and the need for conversion to open cholecystectomy (Chi-square value: 106.0000, p-value: <0.0001). Moderate difficulty was most common (50%), with severe and extreme difficulties leading to all conversions. Factors like gallbladder appearance, BMI, and identification time of the cystic artery and duct significantly influenced operative challenges. The system showed potential in predicting surgical outcomes and enhancing decision-making. Conclusion: The proposed scoring system effectively quantifies operative difficulties in laparoscopic cholecystectomy, offering a predictive tool for assessing the risk of conversion. Its adoption could lead to better surgical planning, reduced conversion rates, and improved patient outcomes. [ABSTRACT FROM AUTHOR]