Risk factors influencing conversion of laparoscopic cholecystectomy to open cholecystectomy

Mohanapriya Thyagarajan; Balaji Singh; Arulappan Thangasamy; Shobana Rajasekar

doi:10.18203/2349-2902.isj20174495

Authors

Mohanapriya Thyagarajan Department of General Surgery, Sri Ramachandra Medical College, Chennai, Tamil Nadu, India
Balaji Singh Department of General Surgery, Sri Ramachandra Medical College, Chennai, Tamil Nadu, India
Arulappan Thangasamy Department of General Surgery, Sri Ramachandra Medical College, Chennai, Tamil Nadu, India
Shobana Rajasekar Department of General Surgery, Kilpauk Medical college, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-2902.isj20174495

Keywords:

Conversion, Gall bladder, Laparoscopic cholecystectomy, Risk factors

Abstract

Background: Gall stone disease is a common disease affecting human beings. Over the past two decades, laparoscopic cholecystectomy has become gold standard for the surgical treatment of gallbladder disease. The advantages of laparoscopic cholecystectomy over open surgery are a shorter hospital stay, less postoperative pain, faster recovery, better cosmoses. This study was planned to identify the circumstances and the risk factors influencing the conversion of laparoscopic cholecystectomy to open procedure.

Methods: This is a Prospective study conducted over a period of 24 months. A total of 50/500 patients who were electively posted for laparoscopic cholecystectomy and got converted into open cholecyctectomy were included in the study. The Factors recorded and analysed were Age and Sex of the patient, presence of diabetes mellitus, previous episode of Acute Cholecystitis, Body Mass Index, presence of abdominal scar, total count, Ultrasonagram Abdomen findings of Gallbladder wall thickness and presence of pericholecystic fluid.

Results: In our study, it has been observed that Patient Related Factors - Age >50yrs, Male gender, Presence of Diabetes Mellitus, Obesity, previous Abdominal surgeries and Disease Related Factors - previous episode of Acute Cholecystitis, presence of Acute Cholecystitis, Gallbladder wall thickness >4mm, presence of Pericholecystic fluid were found to be significant risk factors in conversion of laparoscopic to open cholecystectomy.

Conclusions: These risk factors help to predict the difficulty of the procedure and this would permit the surgeon to better inform patients about the risk of conversion from laparoscopic to open cholecystectomy.

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