Objective
To determine the frequency of inability to visualize the Calot’s triangle and hemorrhage leading to conversion of laparoscopic cholecystectomy (LC) to open surgery.
Patients and Methods
This cross sectional study was carried out at Department of Surgery, Chandka Medical College Teaching Hospital, Larkana, Pakistan for six months duration.
Consecutive patients admitted with cholelithiasis who underwent LC were included in the study. Statistical analysis was carried out using SPSS version 10.00.
Results
A total of 113 patients were included in the study. Pain in right hypochondrium was the main presenting symptoms (n=111, 98.2%). Twelve (10.6%) needed conversion. Frequency of distorted Calot’s triangle was 58.3% (7 out of 12) and that of hemorrhage was 16.7% (2 out of 12). In 8.3% (1out of 12), both were responsible for conversion while in 16.7% (2 out of 12) equipment failure and gut perforation were the reason for conversion.
Conclusion
We found a conversion rate of 10.6% to open cholecystectomy. We identified the inability to visualize Calot’s triangle being the most frequent cause for this conversion, although this is highly dependent on subjective evaluation of surgeon, his competencies and experience. This could help in developing future specific guidelines and objective assessment tools for conversion. (Rawal Med J 2011;36:287-290).
Key words: Laparoscopic cholecystectomy, Calot’s triangle, open cholecystectomy, cholelithiasis.
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