Difficulty Score of Cho et al for Performing a Laparoscopic Cholecystectomy

Description

Cho et al developed a score for describing the difficulty in the performance of a laparoscopic cholecystectomy. This can help compare outcomes and complications following surgery. The authors are from Ewha Womans University and Mokdong Hospital in Korea.

Steps in the procedure:

(1) access into the peritoneal cavity

(2) dissection of adhesions from the gallbladder

(3) dissection of Calot's triangle

(4) dissection of the gallbladder bed

(5) extraction of the gallbladder from the abdomen

Parameter	Finding	Points
access into the peritoneal cavity	not difficult	0
	difficult	1
dissection of adhesions	not difficult	0
	difficult	1
dissection of Calot's triangle	not difficult	0
	difficult	1
dissection of the gallbladder bed	not difficult	0
	difficult	1
extraction of the gallbladder	not difficult	0
	difficult	1

where:

• Calot's triangle is defined by the cystic artery (superior), hepatic duct (medial) and cystic duct (inferior).

total difficulty score =

= SUM(points for all of 5 steps)

Interpretation:

• minimum score: 0

• maximum score: 5

• The higher the score the more difficult the procedure.

Modification:

• An obvious modification would be to change the grading to easy, slightly difficult, somewhat difficult, difficult and impossible.

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Description

Specialty

ICD-10