Determinants of conversion of laparoscopic cholecystectomy to open cholecystectomy
Abdul Ghani Shaikh, Aijaz Ahmed Memon, Saeed Ahmed Shaikh, Abdul Ghaffar Pirzado.
Abstract
Objective: To determine the reasons for conversion of laparoscopic cholecystectomy to open cholecystectomy.
Methodology: This descriptive study was performed at department of Surgery, Chandka Medical College Teaching Hospital/Shaheed Mohtarma Benazir Bhutto Medical University, Larkana, Pakistan from July 2011 to June 2016. All patients with gall stones, acute and chronic cholecystitis aged 15 years & above underwent laparoscopic cholecystectomy.
Results: Out of 1775 patients in this study, 1322(74.4%) were females and 453(25.6%) males. Age ranged from 22 to 65 years (mean 44±13.7). Out of 1775 patients, 35(1.97%) required conversion to open and among these, 24(1.81%) were females and 11(2.42%) were males (P= 0.3897). The most common reason for conversion to open was dense adhesions due to cholecystitis in 9(0.50%) patients followed by obscure anatomy with severely inflammed gall bladder in 8(0.45%) patients, 6(0.33%) patients with empyma gall bladder, 5(0.28%) patients due to suspicion of bile duct injury, 4(0.22%) patients due to duodenal injury and 2(0.11%) with cholecysto-enteric fistula.
Conclusion: In this study, 2% patients required conversion to open and the frequent reasons were dense adhesions and obscure anatomy.
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