Radiological Predictors for Difficult Single Incision Laparoscopic Cholecystectomy

Abstract

Background: Single-incision laparoscopic cholecystectomy (SILC) has been developed to further minimize the invasiveness of laparoscopic cholecystectomy by reducing the number of incisions. Knowledge of preoperative clinical factors to predict difficult SILC may be used for the preoperative counselling of the patients regarding the successful outcome of the surgery as well as to predict the risk of conversion preoperatively for selected patients, prepare the patient psychologically and minimise the procedure related cost. Objective: The present study was conducted to know about radiological predictors for difficult SILC. Methods: The study was a hospital based prospective observational study where 50 patients undergoing elective laparoscopic cholecystectomy due to gall stone diseases were included in the study. Multiple logistic regression analysis was done to predict difficult single incision laparoscopic cholecystectomy. Results: Out of 50 patients 15 patients underwent difficult SILC, while 35 patients had undergone easy single incision laparoscopic cholecystectomy independent risk factors in multivariate logistic regression analysis for difficult SILC were: contracted or distended gall bladder on ultrasound, longer umbilicus to Calot’s triangle distance (UCD) on MRI. Conclusion: Radiological Factors associated with difficult SILC contracted or distended gall bladder on ultrasound and longer umbilicus to Calot’s triangle distance on MRI.