Predictors of Difficult laparoscopic cholecystectomy in patients of Zagazig University Hospital

BackgroundOne of the most frequent causes of severe epigastric pain is cholelithiasis. GB stones and other illnesses affect 10–15% of persons with epigastric pain. cholecystectomy is the most common procedure carried out , it is asymptomatic in nearly (>80%) of these patients . This study is to determine the intraoperative and preoperative markers for challenging laparoscopic cholecystectomy and to provide a predictive score system.methods: 50 patients between the ages of 25 and 60 who had laparoscopic cholecystectomy at Zagazig university Hospital during the period from March 2025 to June 2025Age, sex, body weight, history of acute cholecystitis with hospitalisation, history of endoscopic retrograde cholangiopancreatography and chronic conditions (such as diabetes or hypertension) were all included in the comprehensive history. Abdominal ultrasonography was used to diagnose and confirm cholelithiasis in individuals who complained of abdominal pain.Results:study's overall findings showed that 33 (66%) patients, 14(28%) cases, and 3 (6%) cases had easy, difficult, and extremely difficult LC,respectively. There was no correlation between difficult LC and the age or gender item. A score greater than 4.5 was linked to a difficult cholecystectomy, according to the ROC curve. As the sensitivity (50%) and specificity (93.9%) rise, so does the score; the AUROC curve is 0.749; P= (0.007).Conclusion: The number of acute cholecystitis attacks, palpable gall bladder, and impactedstones are the clinical predictors of preoperative difficult laparoscopic cholecystectomy. The thickness of the gall bladder wall and the existence or lack of pericholecystic collection are the radiographic predictors.