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    • The Value of Preoperative Ultrasound In Predicting Technical Difficulties During Laparoscopic Cholecystectomy

    Ahmed Mahmoud Hussein1 M.D.; Ahmed Abd Alaziz Mohammad1 M.D.; Ahmed Mohammed Ahmed Nasser2 M.Sc.
    1Department of General Surgery, Faculty of Medicine, Cairo University, Egypt. 2Department of General Surgery, Omm El-Mesreyeen Hospital, Giza Governorate, Egypt

    Background: In spite of advances made in laparoscopy with the development of higher technical skills, there is still a reported significant incidence of serious complications during laparoscopic cholecystectomy which may necessitates conversion to open surgery and in turn; may affect the post operative outcome. Aim of work: Evaluation of preoperative sonography as a simple non-invasive method in predicting technical difficulties in laparoscopic cholecystectomy. Patients and Methods: Prospective clinical trial study included 100 patients with chronic calcular cholecystitis underwent laparoscopic cholecystectomy. Preoperative US was done for all of them measuring four parameters, namely, gall bladder size and wall thickness, stone size and mobility. Then detecting their relation with intraoperative technical difficulties. Results: Operation time was more with thickened gall bladder wall and with impacted stones. More technical difficulties were encountered with stone impaction and size of gall bladder while conversion to open was higher with thickened gall bladder wall.Conclusion : In spite of the importance in predicting operation time and technical difficulties, no single sonographic parameter was reliable in predicting risk of conversion to open surgery. Keywords: Laparoscopic cholecystectomy, Technical difficulties, Preoperative sonography, Impacted stones, Gall bladder.

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