Preoperative Prediction of difficult Laparoscopic Cholecystectomy using Randhawa and Pujahari Scoring System for Acute Cholecystitis, the Optimal Time for Surgery

Document Type : Original Article

Authors

1 Professor of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

2 Lecturer of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

3 MBBCh, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

https://doi.org/10.21608/aimj.2025.446488

Abstract

Background: In chronic calculous cholecystitis and acute calculous cholecystitis, laparoscopic cholecystectomy (LC) is the surgical treatment of choice for gallstone symptoms. However, for a variety of reasons, some patients need to be converted to open surgery. Predicting "difficult laparoscopic cholecystectomy" in advance of surgery during acute attacks could help improve patient safety and lower therapy costs.
Aim and objectives: In order to determine how well the Randhawa and Pujahari preoperative grading system predicts challenging laparoscopic procedures for patients with acute cholecystitis.
Subjects and methods: The general surgery department at Al-Azhar University Hospitals undertook prospective observational research. From November 2023 to December 2024, 30 patients with acute cholecystitis underwent LC at the Cairo Fatemic hospitals. Based on the patient's history, physical exam, and radiological findings, a scoring system developed by Randhawa and Pujahari was assigned the day prior to the procedure.
Results: The Kruskal-Wallis test showed a statistically significant relationship between the intraoperative difficulty evaluation and the preoperative difficulty score, with a mean of 2.4±1.4 for easy status and 6.6±3.4 for difficult status, and a p-value of 0.001 for both.
Conclusion: Acute cholecystitis LC difficulty can be assessed using the valid Ranhawa and Pujahari rating system.
 
 

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