USEFULNESS OF RANDHAWA AND PUJAHARI SCORING SYSTEM FOR ASSESSMENT OF DIFFICULTY DURING LAPAROSCOPIC CHOLECYSTECTOMY PROCEDURE

BACKGROUND We wanted to evaluate the difficulties encountered during laparoscopic cholecystectomy. METHODS 150 adult patients fulfilling the inclusion criteria of study, were enrolled. Using Preoperative predicting score of Randhawa et al. (2009). preoperative score of all the patients was calculated and 99 (66.0%) patients with pre-operative score of 0-5 were classified as Group I and considered Easy for surgery, rest 51 (34.0%) patients had pre-operative score 6-10 were classified as Group II and were considered Difficult for surgery. No patients had pre-operative score >10 as very difficult for surgery. RESULTS Age of patients ranged between 22-60 years and mean age was 39.62 +/- 11.24 years and majority of the patients (60.0%) were females and were found to be comparable among Easy (Group I) and Difficult (Group II) for surgery. The role of predictive risk factors on the final outcome has been assessed. We found that only previous history of hospitalization, BMI > 27.5 kg/m(2), abdominal scar and pericholecystic collection were significant contributors in prediction of level of ease of surgery. Role of age, male gender, palpability and thickness of GB wall was not found to be significant. CONCLUSIONS This study validated the usefulness of Randhawa and Pujahari scoring system for assessment of difficulty during laparoscopic cholecystectomy and found it comparable to other existing scoring systems. Despite this, a compromised efficacy of different scoring systems to miss difficulty remains a question to be answered. Further studies to identify more variables that could be included to improvise the scoring systems are recommended.