Preoperative predictors of difficult laparoscopic cholecystectomy after percutaneous transhepatic gallbladder drainage in patients with cholecystitis

Abstract

Highlights • First prediction model for difficult LC after PTGBD.• Four independent predictors: CRP, PCF, GDAI, HU.• Nomogram shows excellent discrimination (AUC = 0.903).• Guides surgeon selection and adhesion preparedness.• Integrates inflammation and local anatomical changes.