Study of Correlation of Preoperative Clinical, Laboratory, Sonological and Peroperative Findings in Gall Stone Disease

Gallstone disease is the pathologic state of stones or calculi within the gall bladder lumen and biliary tree. A common digestive disorder worldwide, worldwide occurrence varies from 6-20%. The definitive management of symptomatic gallstones is surgical. The two surgical approaches are conventional and laparoscopic. Important intraoperative considerations during laparoscopic cholecystectomy include time taken for surgery, the degree of difficulty encountered during surgery and conversion to conventional/open cholecystectomy (OC). Most common reason for conversion to laparotomy (open through a midline or subcostal skin incision) is the inability to identify important anatomic structures due to distorted anatomy from previous surgeries, inflammation or anatomic anomalies/variations. Other potential causes for conversion are intraoperative complications (vascular, bowel or bile duct injury). It is helpful to determine the risk of conversion of an LC to OC beforehand. This may allow the patients to be better prepared for the surgery and to plan their absence from work. Also, such prediction may allow a surgeon to be better prepared, to take extra precautions to reduce intraoperative complications and to convert from LC to OC at an earlier stage. It may therefore, be useful to assess and determine reliable pre-operative factors which may predict the duration and degree of difficulty in performing cholecystectomy and may predict conversion of laparoscopic to open cholecystectomy. The study was a prospective randomized study done in the department of surgery in our institution for a period of one year. Total 100 patients diagnosed with cholelithiasis and undergoing laparoscopic cholecystectomy were included in the study. Patients were examined for a detailed preoperative history, physical examination and preoperative biochemical and radiological investigations and correlation to various peroperative parameters was done. It was concluded that properly performed preoperative workup might help to plan a better and laparoscopic cholecystectomy.