Objective: To determine the frequency of difficult laparoscopic cholecystectomy that needs to open procedure in patients undergoing cholecystectomy for thick walled gall bladder.

Study Design: Retrospective/observational study

Place and Duration of Study: Department of Surgery, Mardan Medical Complex, Mardan from 1st January to 31st December, 2019.

Methodology: One hundred patients of both genders with gall bladder wall thickness more than 3mm were included. Patient’s demographics were recorded after taking written consent. All the patients were undergoing laparoscopic cholecystectomy. Per-operative complications, frequency of difficult laparoscopic cholecystectomy which needs conversion to open procedure and post-operative wound infection were examined. Data was analyzed by SPSS 24.0.

Results: Seventy two (72%) were females and 28 (28%) patients were males with mean age 35.27±14.18 years. Mean duration of disease was 4.24+3.98 years. Mean gall bladder thickness was 4.28±1.06 mm. Excessive bleeding was the commonest preoperative complication found in 40 (40%) patients. Difficult laparoscopic cholecystectomy was found in 14 (14%) patients need conversion to open procedure. Post-operative wound infection found in 18 (18%) patients.

Conclusion: Frequency of difficult laparoscopic cholecystectomy which needs conversion to open procedure was high in patients with thick walled gall bladder

Keywords: Cholecystectomy, Laparoscopic, Open procedure, Bleeding, Wound infection