Essential strategies for the management of challenging laparoscopic cholecystectomy procedures

doi:10.4240/wjgs.119524

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Surg. Jun 27, 2026; 18(6): 119524
Published online Jun 27, 2026. doi: 10.4240/wjgs.119524

Table 4 Sugrue et al[97] difficulty scoring system for laparoscopic cholecystectomy

Factors	Score¹
Adhesions covering gallbladder	1-3
Distended or contracted gallbladder	1
Unable to grasp gallbladder	1
Stone ≥ 1 cm impacted in Hartmann’s pouch	1
BMI > 30	1
Time to identify cystic artery/duct > 90 minutes	1
Severe inflammation, necrosis, perforation	1

¹Grading: Easy 0-1, moderate 2-4, difficult 5-7, extreme 8-10.

BMI: Body mass index.

Full Size Table

Citation: Pavlidis ET, Mouratidou C, Marneri AG, Kofinas A, Stavrati KE, Pavlidis TE. Essential strategies for the management of challenging laparoscopic cholecystectomy procedures. World J Gastrointest Surg 2026; 18(6): 119524
URL: https://www.wjgnet.com/1948-9366/full/v18/i6/119524.htm
DOI: https://dx.doi.org/10.4240/wjgs.119524

Pavlidis ET, Mouratidou C, Marneri AG, Kofinas A, Stavrati KE, Pavlidis TE. Essential strategies for the management of challenging laparoscopic cholecystectomy procedures. World J Gastrointest Surg 2026; 18(6): 119524 [DOI: 10.4240/wjgs.119524]

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