الفهرس 
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Abstract
Laparoscopic cholecystectomy has become the gold standard procedure for cholelithiasis all over the world and replaced open procedure even in cases predicted to be difficult. Laparoscopic cholecystectomy (LC) may be defined as difficult according to intraoperative obstacles that face the surgeon from the insertion of verres needle till the extraction of the GB and make the operation longer, more difficult to complete it laparoscopically and more liable to complications so it occasionally needs conversion to open cholecystectomy (OC).
Many factors can predict difficult laparoscopic cholecystectomy preoperatively.
These factors may be history factors, clinical factors and radiological factors.
All these factors can help both the patient and the managing surgeon.
The present study was carried out on 132 patients with symptomatic gallstone disease admitted to the department of surgery, Faculty of medicine, Menoufia university hospital from October 2018 to October 2019. Excluding cases of patient contraindication to patients who have any contraindication to laparoscopic surgery & Unfit for general anesthesia, Pregnancy, severe portal hypertension.
And open conversion due to equipment failure.
Aim of this study was to study factors that predict difficult Laparoscopic Cholecystectomy preoperatively through a special scoring method depending on recent scoring systems and difficulty grading for experts and trainees to help to get an idea of potential difficulty to be faced during surgery.
Among all patients there were 83 females and 49 males. The mean age was 45.63 ± 7.54 years. BMI of the patients was with mean 28.44 ± 5.65 with range from 19 to 39.
History in details was taken from all patients, detailed physical examination and radiological investigations including ultrasonography especially done to all the included patients.