Table 2 Operative Grading System for Cholecystitis Severity
From: Grading operative findings at laparoscopic cholecystectomy- a new scoring system
Gallbladder appearance | |||||||
|---|---|---|---|---|---|---|---|
Adhesions < 50% of GB | 1 | ||||||
Adhesions burying GB | 3 | ||||||
Max | 3 | ||||||
Distension/Contraction | |||||||
Distended GB (or contracted shrivelled GB) | 1 | ||||||
Unable to grasp with atraumatic laparoscopic forceps | 1 | ||||||
Stone ≥1 cm impacted in Hartman’s Pouch | 1 | ||||||
Access | |||||||
BMI >30 | 1 | ||||||
Adhesions from previous surgery limiting access | 1 | ||||||
Severe Sepsis/Complications | |||||||
Bile or Pus outside GB | 1 | ||||||
Time to identify cystic artery and duct >90 minutes | 1 | ||||||
Total Max | 10 | ||||||
Degree of difficulty | |||||||
A Mild | <2 | ||||||
B Moderate | 2–4 | ||||||
C Severe | 5–7 | ||||||
D Extreme | 8–10 | ||||||