Clinical Evaluation of Predictors for Difficult Cholecystectomy in Sympto-matic Gallstone Patients

Background: Laparoscopic cholecystectomy (LC) has become the gold standard for treating gallbladder diseases.However, some cases pose intraoperative difficulties due to anatomical variations or comorbidities, necessitatingconversion to open surgery. Identifying predictive risk factors is essential to anticipate and manage these chal-lenges.Aim: To assess demographic and clinical ‘factors associated with difficult laparoscopic cholecystectomy (LC)and enhance pre-operative risk stratification.Methodology: The present study was a hospital-based observational study of patients undergoing elective oremergency cholecystectomy in the Department of General Surgery, Patna Medical College and Hospital, Biharbetween Jan 2017 and Dec’ 2018. The study included 80 patients assessed by demographic data, history andintraoperative data. Surgeries were classified as an “easy” or “difficult” laparoscopic cholecystectomy based ‘ondefined criteria. Data were analyzed using SPSS v27 with statistical significance set at p<0.05.Results: Older age (41–60 years, p=0.016), male gender (p=0.031), and BMI ≥25 kg/m² (p<0.0001) were signif-icantly associated with difficult LC. Key clinical predictors included diabetes mellitus (p<0.0001), sickle celldisease (p=0.03), impacted calculi (p=0.036), pericholecystic collection (p=0.017), adhesions in the triangle ofCalot (p<0.0001), previous abdominal surgery’ (p=0.004), and prior hospitalizations (p<0.0001).Conclusion: This study highlights that age, gender, BMI, and specific clinical conditions strongly predict thedifficulty of LC. Preoperative recognition of these risk factors can aid in surgical planning, improve patient coun-seling, reduce complications, and optimize resource allocation.