DOI: http://dx.doi.org/10.18203/2349-2902.isj20181423

Causes and incidence of laparoscopic cholecystectomy conversion to open cholecystectomy in Al Karama teaching hospital

Mohammed Reda Al Ghadhban, Hussein Ali Alkumasi, Mohammed Saleem Meziad

Abstract


Background: There is no doubt that laparoscopic cholecystectomy replaced open cholecystectomy as standard procedure for the treatment of symptomatic cholelithiasis. Conversion from laparoscopic cholecystectomy to open cholecystectomy is still required in many circumstance, this study aimed at exploring causes and incidence of conversion.  

Methods: This is a prospective study of 200 cases of laparoscopic cholecystectomy cases were performed in ALKARAMA Teaching Hospital from January2009 to January 2011. All cases were followed at the time of surgery by obtaining data sheet for the patient’s age, sex, time from the introduction of ports till decision of conversion and the cause of conversion if present.

Results: Out of 200 laparoscopic cholecystectomy, 12 cases were converted into open cholecystectomy (6%). The major causes were : dense adhesions (4),  bleeding (2), anatomical difficulties (2), impacted stone in Hartmann pauch (2), dilated cystic duct (1) and sever inflammation (1). Two of the conversions are males from 45 male patients underwent laparoscopic cholecystectomy, 10 cases are females from 155 female patients underwent laparoscopic cholecystectomy so the percentage of conversion for male patients is 4.44 % while for female patients is 6.45%.

Conclusions: The conversion rate in this study is 6% and the most common cause for conversion is dense adhesions in the Calot’s triangle, no biliary duct injury that need conversion is found in this study and the rate for conversion is higher in female patients.


Keywords


Cholecystectomy, Conversion, Incidence, Laparoscopic

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References


Traverso LW. Carl Langenbuch and the first cholecystectomy. Am J Surg. 1976;132(1):81-2.

Blum CA, Adams DB. Who did the first laparoscopic cholecystectomy? J Minim Access Surg. 2011;7(3):165.

Novitsky YW, Kercher KW, Czerniach DR, Kaban GK, Khera S, Gallagher-Dorval KA, et al. Advantages of mini-laparoscopic vs conventional laparoscopic cholecystectomy: results of a prospective randomized trial. Arch Surg. 2005;140(12):1178-83.

Scott TR, Zucker KA, Bailey RW. Laparoscopic cholecystectomy: a review of 12,397 patients. Surg Laparosc Endosc. 1992;2(3):191-8.

Radu D, Olariu S, Marinescu A, Georgescu D, Teodorescu M. Laparoscopic Cholecystectomy, rate and predictors for conversion. Surg Endosc. 2011; 25:54-148.

Sikora S, Kumar A, Saxena R, Kapoor V, Kaushik S. Laparoscopic cholecystectomy can conversion be predicted? World J Surg Oncol. 1995;19(6):858-60.

Baird D, Wilson J, Mason E, Duncan T, Evans J, Luke J, et al. An early review of 800 laparoscopic cholecystectomies at a university-affiliated community teaching hospital. Am Surg. 1992;58(3):206-10.

Karayiannakis A, Polychronidis A, Perente S, Botaitis S, Simopoulos C. Laparoscopic cholecystectomy in patients with previous upper or lower abdominal surgery. Surg Endosc. 2004;18(1):97-101.

Merdad AM. Laparoscopic cholecystectomy: Rate and predictors for conversion. Saudi J Gastroenterol. 1999;5(3):117.

Livingston EH, Rege RV. A nationwide study of conversion from laparoscopic to open cholecystectomy. Am J Surg. 2004;188(3):205-11.

Tayeb M, Raza SA, Khan M, Azami R. Conversion from laparoscopic to open cholecystectomy: multivariate analysis of preoperative risk factors. J Postgrad Med. 2005;51(1):17.

Sahir Mahir Khabbaz Al Azzawy, Conversion Rate in Laproscopic cholecystectomy in Al Jumhoory Hospital. Iraqi Journal of Medical Sciences. 2004;5(6):15-7.

Kok K, Mathew V, Tan K-K, Yapp S. A prospective review of laparoscopic cholecystectomy in Brunei. Surg Endosc.1998;8(2):120-2.

Greenwald JA, McMullen HF, Coppa GF, Newman RM. Standardization of surgeon-controlled variables: impact on outcome in patients with acute cholecystitis. Ann Surg. 2000;231(3):339.