Lap chole can be difficult and some times very difficult .All of us as lap surgeons experience it in day to day practice If there is a classification ,we can document it.
It probably will help in billing,explanation and for legalities.
Dear Dr. Reddy:
The term difficult GB has been often used in the literature, but there is no defined criteria. From the view point of a surgeon, it is more reasonable to be called as a complicated GB. Since the inflammation severity is not always equal to technical difficulty. I have proposed an inflammation grading system for laparoscopic cholecystectomy according to technical difficulty and revised it in the flowing two publications and defined Grade V and VI as difficult GB. Complete articles can be found in the Research Gate.
1. Chang YC. A proposed inflammation grading system for laparoscopic cholecystectomy. Hepatogastroenterology 2005;52:33-36.
2. Chang YC. A predictive analysis of interval cholecystectomy according to GB inflammation status during laparoscopic cholecystectomy. Анналы Хирургической Гепатологии (Москва) 2016; 21(1): 59-77. Ann Surg Hepatol (Moscow) 2016; 21(1): 59-77.
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