
Correlation of Preoperative Scoring System with Intraoperative Scoring System for Predicting Difficult Laparoscopic Cholecystectomy: A Research Protocol
Correspondence Address :
Dr. Amol Ashok Gupta,
G12, Raghobaji Hostel Sawangi, Wardha-442001, Maharashtra, India.
E-mail: amolgupta1121@gmail.com
Introduction: Laparoscopic Cholecystectomy (LC) is the gold standard of care for benign gallbladder disease. The incidence of conversion from LC to open cholecystectomy is 14.3%. A high degree of anatomical variation exists in the cystic duct, cystic artery and gallbladder, making this surgery challenging at times, even in the hands of the most experienced surgeons.
Need of the study: Understanding the correlation between the preoperative score and the intraoperative score early in the disease course can facilitate timely conversion to open surgery, thereby reducing the risk of inadvertent injury. Additionally, this approach can improve the efficiency of operating room scheduling and ensure that a more skilled laparoscopic surgeon is available. Furthermore, it can assist surgeons in managing complications or legal issues that may arise postoperatively.
Aim: This study aims to assess the correlation between preoperative grading and an intraoperative scoring system to forecast difficulties in LC and the potential for conversion to open cholecystectomy.
Materials and Methods: A prospective observational study will be conducted in the inpatient department of General Surgery at Acharya Vinoba Bhave Rural Hospital (AVBRH) in Sawangi, Wardha, Maharashtra, India, from March 2024 to February 2026. A total of 35 patients with cholelithiasis will be included in the study. Patients will be scored based on a preoperative scale (the Modified Randhawa scoring system) and counselled regarding the difficulty and possibility of conversion, which will then be correlated with an intraoperative score to assess their predictive value for the risk of conversion. The correlation between preoperative and intraoperative scores will be assessed using Pearson or Spearman correlation coefficients. For intergroup comparisons, the t-test or Mann-Whitney U test will be applied with a 5% significance level. Logistic regression models will be evaluated using the Hosmer-Lemeshow test and ROC curve analysis.
Conversion, Cystic duct variation, Laparoscopic open cholecystectomy, Minimal invasive surgery
DOI: 10.7860/JCDR/2025/77218.21065
Date of Submission: Dec 09, 2024
Date of Peer Review: Jan 04, 2025
Date of Acceptance: May 09, 2025
Date of Publishing: Jun 01, 2025
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA
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ETYMOLOGY: Author Origin
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