Preoperative and Operative Clinical, Laboratory and Radiological Predictors of Difficult Cholecystectomy and Their Management

Background: Cholethiasis is the most common biliary pathology. Stones of the bile are present in 10 to 20% of the general population of the globe. Laparoscopic cholecystectomy (LC) is the standard medical therapy for people with gallstones. Several randomised controlled trials and systematic reviews demonstrated the effectiveness and safety of lc in the treatment of symptomatic colelithiasis. Work objective: The aim of this study is to investigate factors, in particular the pre-operative predictability of difficult cholecystectomies and the possibility of conversion to open cholecystectomy from the laparoscope and to develop managerial strategies to achieve a secure operating element in these difficult cases. Patients and methods: A prospective randomised study was conducted with the approval of the Internal Ethical Committee. Research was carried out from May 2019 to December 2020 at Benha University's General Surgery Department, Al Fath Hospital, Al Mabara Hospital. There were 100 study participants who underwent optional laparoscopic cholecystectomy. Results: Additional study is continued using patient clinical criteria, laboratory and radiographic criteria. Our study demonstrates extremely significant connections between easiness or difficulty in dissection and pain since discomfort is usually induced by inflammatory changes in GB and SO. Our study has demonstrated that access to the peritoneal cavity and BMI are not linked to sex. In our study, there was no statistical significance of the age parameter. Due to the smaller sample size, the liver paranhydroxy disease in our study is particularly important in the difficult LC or OC conversion as Cuschierei believed that liver fibrosis is associated with an increased risk of bleeding, difficulty separating gb from liver and a lack of cleavage between liver and liver. Peritoneal cavity access was not statistically significant with any parameter in our study, but male sex, obesity and the use of safe locations for insertion are extensively expanded. No significant link between stones larger than 1 cm and LC issues or conversion to OC was found throughout our study. Conclusion: Cholecystectomy is one of the early procedures in more than 20 percent of the population owing to high cholitis prevalence. Laparoscopic cholecystectomy has been considered as a standard technique of cholecystectomy owing to better visibility, less pain and rapid recuperation. Cholecystectomy effects for hepato-gallbladder and vascular damage are less than 1-3 percent but very severe and costly 5-10% missing diagnoses, over 20% congenital hepatobiliar and vascular anomalies, and surgical intervention in acute colecystitis complications 20 percent of cases are the main causes of serious consequences. Pre-operative and post-operative safety precautions are required to avoid such issues All local and international safety requirements have been applied, extended even in our study and issues have been reduced to less than 1 percent, but more and more research and clinical trials still need us to develop clean and effective safety processes.