DOI: http://dx.doi.org/10.18203/2349-2902.isj20163501

Predicting the conversion of laparoscopic to open cholecystectomy:an experience in a tertiary care hospital of central India

Ashish Pratap Singh, Priyank Sharma, Sajith Babu S. M, A.P. S. Gaharwar

Abstract


Background: Laparoscopic cholecystectomy is the gold standard procedure for symptomatic cholelithiasis. However some laparoscopic cholecystectomies need to be converted into an open cholecystectomy for various reasons. So it will be very helpful if criteria can be developed for the prediction of difficult laparoscopic cholecystectomies. The objective of this study was to evaluate pre-operative risk factors amounting to the conversion of laparoscopic cholecystectomy into an open cholecystectomy.

Methods: This is a prospective study in which 255 patients presenting with definitive diagnosis of cholelithiasis meeting the inclusion criteria, undergoing laparoscopic cholecystectomy were included in the study. Their demographic data, symptomatology and associated illness were documented.

Results: Out of 255 patients 19 (7.4%) patients required conversion to open cholecystectomy. In converted group of patients, 73.33% patients were more than 50 years , 52.63% had BMI more than 30, 68.42% had >2 episodes of cholecystitis, 63.16% had leukocytosis, 68.42% had gallbladder wall thickness >3 mm, 63.16% had pericholecystic collection.

Conclusions: Clinical and ultrasonographic factors can help to predict difficult laparoscopic cholecystectomy and likelihood of conversion of laparoscopic cholecystectomy to open surgery.


Keywords


Conversion,Laparoscopic cholecystectomy,Open cholecystectomy

Full Text:

PDF

References


Brett M, Barker DJ. The world distribution of gall stone. Int J Epidemiol. 1976:5:335.

Conference NC. Gallstones and laparoscopic cholecystectomy. JAMA. 1992;269:1018-24.

Tiwary KS, Agarwal N, Prasanna G, Khanna R. Predictive factors for difficult surgery in laparoscopic cholecystectomy for chronic cholecystitis. Int J Surg. 2008;16(12):11.

Sharma SK, Thapa PB, Pandey A, Kayestha B, Poudyal S. Predicting difficulties during laparoscopic cholecystectomy by preoperative ultrasound. Kathmandu University Med J. 2007;5(17):8-11.

Nachnani J. Supe a: pre-operative prediction of difficult laparoscopic cholecystectomy using clinical and ultrasonograpic parameters. Indian J Gastroenterol. 2005;24:16-8.

Fried GM, Barkun JS, Sigman HH, Joseph L, Clas D, Garzon J, et al. Factors determining conversion to laparotomy in patients undergoing laparoscopic cholecystectomy. Am J Surg. 1994;167:35-41.

Randhawa JS, Pujahari AK. Preoperative prediction of difficult lap chole: a scoring method. Indian J Surg. 2009;71:198-201.

Vivek MK, Augustine AJ, Rao R. A comprehensive predictive scoring method for difficult laparoscopic cholecystectomy. J Min Access Surg. 2014;10:62-7.

Liu C. Factors affecting conversion of laparoscopic cholecystectomy to open surgery. Arch Surg. 1996;131(1):98.

Ibrahim S, Hean TK, Ho LS, Ravintharan T, Chye TN, Chee CH, et al. Risk factors for conversion to open surgery in patients undergoing laparoscopic cholecystectomy. World J Surg. 2006;30:1698-704.

Bedirli A, Sakrak O, Sozuer EM, Kerek M, Güler I. Factors effecting the complications in the natural history of acute cholecystitis. Hepatogastroenterology. 2001;48:1275-58.