Comparison of difficult vs simple laparoscopic cholecystectomy in a tertiary care hospital.

Abstract

Objective: To determine the percentage of patients with difficult laparoscopic cholecystectomy for gall bladder calculi done and to compare the various factors and outcomes of simple and difficult laparoscopic cholecystectomy for gall bladder calculi done in our tertiary care hospital. Study Design: Cross sectional study. Setting: Department of General Surgery, Liaquat University Hospital, Hyderabad. Period: March to Aug 2025. Methods: A total of 73 patients aged 20–70 years, scheduled for LC, were enrolled using non-probability consecutive sampling. Difficulty was assessed intraoperatively based on anatomical and technical factors. Patient demographics, comorbidities, operative time, and hospital stay were recorded and analyzed using SPSS v26. Results: Simple LC was performed in 74.0% of the 73 patients, while the remaining 26.0% underwent difficult LC. The patients had a mean age of 44.15 ± 15.23 years and a mean BMI of 25.98 ± 4.41 kg/m². No significant relationships were found between LC difficulty and factors such as age, sex, BMI, diabetes, hypertension, or dyslipidemia. However, prolonged hospitalization (>8 days) was significantly associated with difficult LC (p = 0.003). Conclusion: Difficult LC was observed in over one-fourth of patients and was significantly associated with prolonged hospitalization. Preoperative identification of high-risk cases can improve surgical preparedness and reduce complications.