Validation of the G10 scoring system in predicting conversion from laparoscopic to open cholecystectomy in department of surgery at a tertiary medical centre of North India: a prospective observational study

Ankush Chauhan; Pawan K. Singh; Yukteshwar Mishra; Neelima Verma

doi:10.18203/2349-2902.isj20253449

Authors

Ankush Chauhan Department of General Surgery, GSVM Medical College Kanpur, Kanpur Nagar, Uttar Pradesh, India
Pawan K. Singh Department of General Surgery, GSVM Medical College Kanpur, Kanpur Nagar, Uttar Pradesh, India
Yukteshwar Mishra Department of General Surgery, GSVM Medical College Kanpur, Kanpur Nagar, Uttar Pradesh, India
Neelima Verma Department of Pathology, GSVM Medical College Kanpur, Kanpur Nagar, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2349-2902.isj20253449

Keywords:

Laparoscopic cholecystectomy, Intraoperative risk assessment, G10 scoring system, Conversion to open surgery, Cholelithiasis complications

Abstract

Background: Laparoscopic cholecystectomy (LC) is the gold standard for managing symptomatic cholelithiasis. However, intraoperative challenges may necessitate conversion to open cholecystectomy (OC), which increases morbidity. The G10 score aims to stratify surgical difficulty and predict conversion risk. To evaluate the effectiveness of the G10 scoring system in predicting the need for conversion from LC to OC.

Methods: This hospital-based, prospective observational study was conducted at GSVM Medical College, Kanpur, between November 2023 and November 2025. A total of 146 patients with chronic cholecystitis undergoing elective LC were included. G10 scores were recorded intraoperatively. Data analysis included descriptive statistics, chi-square tests, independent t-tests, logistic regression, and ROC curve analysis using SPSS v23.0.

Results: Among the 146 patients, 24 (16.4%) required conversion to OC. The mean G10 score in the converted group was 6.08 compared to 3.4 in the non-converted group (p<0.001). ROC AUC was 0.87, indicating strong predictive value. Significant predictors included adhesions from previous surgeries, gallstones >1 cm in Hartmann’s pouch, and presence of pus or bile (all p=0.00). Logistic regression model accuracy was 80%.

Conclusion: The G10 score is a reliable intraoperative predictor of conversion from LC to OC. Its application supports better surgical planning and improved patient outcomes.

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