CONVERSION OF LAPAROSCOPIC CHOLECYSTECTOMY TO OPEN CHOLECYSTECTOMY: PREOPERATIVE RISK FACTORS AND INTRAOPERATIVE REASONS

Abstract

Objective: To identify the frequency, associated risk factors and intraoperative reasons for conversion of Laparoscopic Cholecystectomy to open Cholecystectomy.

Study Design: Case series study.

Place and Duration of Study: This study was conducted in department of Surgery, Combined Military Hosptial Rawalpindi, from May to Oct, 2018.

Methodology: Patients admitted for laparoscopic cholecystectomy were included in the study. Demographic information, ASA Score of physical health, Ultrasonogram Abdomen findings and presence of pericholecystic fluid were documented. The reasons for conversion from laparoscopic cholecystectomy (LC) to open Cholecystectomy (OC) for example excessive haemorrhage, visceral injury, equipment failure, injury to Common bile duct were also noted.

Results: In this study 15 (8.77%) patients were converted from laparoscopic cholecystectomy to open cholecystectomy. The most common reason 6 (40%) of conversion was Fibrosis at Calots Triangle and Adhesions due to inflammation. In patients who converted most 10 (66.7%) were 41-60 years old and in patients who had successful laparoscopic cholecystectomy majority 70 (44.9%) patients belonged to age group 21-40 years. The male gender had significantly (p-value <0.05) higher rate of conversion (53.3% vs. 46.7%). There was significant (p-value <0.05) association of ASA score and presence of pericholecystic fluid with rate of conversion.

Conclusion: Male gender, higher ASA score, and presence of pericholecystic fluid are significant contributors for conversion of laparoscopic cholecystectomy to open cholecystectomy. The most common reason for conversion was Fibrosis at Calots Triangle and Adhesions due to inflammation.