Risk and Predictive Factors in Conversion of Laparoscopic to Open Cholecystectomy
Abstract
ABSTRACTBackground: Laparoscopic Cholecystectomy has become the procedure of choice for management of symptomatic gallstone disease. Sometimes it is necessary to convert laparoscopic cholecystectomy to open method. There are several risk factors which contribute to this.
Objectives: To determine the reasons for conversion and if it is possible to predict the factors responsible pre-operatively.
Methods: A prospective case series for one year was done at Al-Yarmouk Teaching Hospital from Oct.1st 2009 to Oct.1st 2010. Eighty patients were included in the study. Detailed history, clinical examination and investigations were obtained. Cases that required conversion from laparoscopic cholecystectomy to open surgery were analyzed and the factors responsible for such conversion were studied.
Results: Out of 80 patients, 10 (12.5%) required conversion to open procedure. Factors responsible for these conversions were intraoperative bleeding (4 patients), adhesions due to previous surgery (1), cystic duct injury (1), abnormal gallbladder (2), unclear anatomy (1) and Mirrizzi syndrome (1).
Conclusions: Conversion of laparoscopic cholecystectomy to open procedure may be life-saving in difficult situations. Risk factors can be recognized pre-operatively and help in planning of surgery. Conversion rate can be reduced by addressing the preventable factors and better training of surgeons.
Keywords: Laparoscopic cholecystectomy, Conversion, Risk factors.
Copyright (c) 2011 Iraqi Medical Journal
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