Objective:To establish a scoring criteria for assessment of the difficulty levels of laparoscopic cholecystectomy (LC).
Methods:The preoperative and intraopertive clinical data of 845 LC patients treated during a period of five years were analyzed. The data were firstly analyzed with univariate methods to screen out the risk factors causing the operative difficulties, which were further identified by multivariate Logistic regression analysis. Numerical values were assigned to these factors to construct the scoring criteria predicting the difficulty levels of LC.
Results:The risk factors causing operative difficulties or even converting to open cholecystectomy (OC) were identified, which included the thickness of gallbladder wall (≥4 mm),  diameter of the common bile duct (≥8 mm), size of gallbladder (≥103 cm3 and <6.3 cm3),  cholecystic inflammation and  severe adhesions in the Calot′s triangle. The scoring criteria for assessing difficulty levels of LC were obtained based on these factors.
Conclusions:The establishment of scoring criteria is clinically helpful for the selection of LC or OC convertion.