Vol. 7, Issue 2, Part B (2025)

Background: Laparoscopic cholecystectomy (LC) is common, but operative difficulty varies widely. The Nassar intraoperative grading system aims to standardize and predict surgical outcomes.
Objective: To assess the degree of difficulty in LC using the Nassar intraoperative scoring system and validate its prediction of conversion and complication rates.
Methods: A retrospective cohort of 105 patients undergoing LC (Jan 2023-July 2024) at BGS GIMS Hospital, Bangalore, was analyzed. Intraoperative grading, patient characteristics, conversion rates, and outcomes were recorded and correlated.
Results: Mean age was 57.6±16.4 years; 58.1% male. The most frequent indication was cholecystitis (44.8%). Emergency LC was performed in 2.9%. Severe and extreme difficulty was seen in 21.0% and 30.5%, respectively. Overall conversion to open surgery was 8.6%. Conversion rate rose substantially with higher Nassar grade (p<0.001).
Conclusions: The Nassar intraoperative grading scale is a reliable predictor of operative difficulty and conversion risk in LC. Its standard use can guide intraoperative planning, training, and risk-adjusted analysis of outcomes.