DOI: http://dx.doi.org/10.18203/2349-2902.isj20221411

A study of factors associated with conversion of laparoscopic cholecystectomy to open cholecystectomy

Pawan Yadav, Sanjeev Agarwal, Dishank Modhia, Arpit Joshi

Abstract


Background: Gall stones are among the most common gastrointestinal illness requiring hospitalization. Laparoscopic cholecystectomy is the procedure of choice for majority of patients. Factors responsible for conversion to open cholecystectomy are adhesions, obscure anatomy at calot’s triangle, CBD injury etc. Aim was to study patients admitted in surgery department and undergoing laparoscopic cholecystectomy in GMCH, Udaipur. Primary objective was to determine factors of conversion of laparoscopic to open cholecystectomy in tertiary care center Secondary objectives were to evaluate the age, sex and etiological factors of cholelithiasis.

Methods: It is a prospective observational study done in 1oo patients admitted in GMCH during January 2020 to June 2021 after informed consent and ethical clearance approval from IRRC. Patients having cholelithiasis were diagnosed with USG, MRCP and/ or ERCP and laparoscopic cholecystectomy was planned. Factors associated for conversion from laparoscopic to open cholecystectomy were studied.

Results: Out of 100 patient 9 were converted to open, adhesion was the most common (8%), (2%) CBD injury, bleed of cystic artery, (1%) bowel injury, (3%) presence of unclear anatomy.

Conclusions: Laparoscopic cholecystectomy is a safe and minimally invasive technique, with only low conversion rate and the commonest cause of conversion in this study was the presence of dense adhesions at Calot's triangle.


Keywords


Cholelithiasis, Cholecystectomy, Adhesions, Conversion, Calot’s triangle

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References


Fischer, Josef E, Ellison EC, Henke PK, Hochwald SN, Tiao GM. Fischer's Mastery of Surgery. 2019.

Al-Mulhim AA. Male gender is not a risk factor for the outcome of laparoscopic cholecystectomy: a single surgeon experience. Saudi J Gastroenterol. 2008;14(2):73.

Edinburgh: Churchill Livingstone. Bailey, H. Bailey & Love's short practice of surgery. 27th edition. 2018.

Bingener-Casey J, Richards ML, Strodel WE, Schwesinger WH, Sirinek KR. Reasons for conversion from laparoscopic to open cholecystectomy: a 10-year review. J Gastrointest Surg. 2002;6(6):800-5.

Ravimohan SM, Kaman L, Jindal R, Singh R, Jindal SK. Postoperative pulmonary function in laparoscopic versus open cholecystectomy: prospective, comparative study. Indian J Gastroenterol. 2005;24(1):6-8.

Ghnnam W, Malek J, Shebl E, Elbeshry T, Ibrahim A. Rate of conversion and complications of laparoscopic cholecystectomy in a tertiary care center in Saudi Arabia. Ann Saudi Med. 2010;30(2):145-8.

Brunicardi F, Andersen D, Billiar T, Dunn D, Hunter J, Pollock RE. Schwartz's Principles of Surgery. 8th Ed. McGraw-Hill Professional. 2004;1187-204.

Thyagarajan M, Singh B, Thangasamy A, Rajasekar S. Risk factors influencing conversion of laparoscopic cholecystectomy to open cholecystectomy. Int Surg J. 2017;4(10):3354-7.

Mallik NR, Bhattacharyya S, Saha AK, Das C. A study on the conversion rate of laparoscopic cholecystectomy to open cholecystectomy and its causes with special reference to rural population. IOSR-JDMS. 2018;17(4):51-7.

Al Ghadhban MR, Alkumasi HA, Meziad MS. Causes and incidence of laparoscopic cholecystectomy conversion to open cholecystectomy in Al Karama teaching hospital. Int Surg J. 2018;5(5):1640-3.

Karigalan K, Haripriya R. A study on safety and efficacy of laparoscopic cholecystectomy in comparison to open cholecystectomy. J Evolution Med Dental Sci. 2014;3(17):4721-31.

Awan NA, Hamid F, Mir IN, Ahmad MM, Shah AA, Asimi A, et al. Factors resulting in conversion of laparoscopic cholecystectomy to open cholecystectomy-institution based study. Int Surg J. 2017;5(1):132-7

Reddy SR, Balamaddaiah G. Predictive factors for conversion of laparoscopic cholecystectomy to open cholecystectomy: a retrospective study. Int Surg J. 2016;3(2):817-20.

Santhanalakshmi K, Vennila M. Observational study of cases subjected to cholecystectomy-laparoscopic vs open method under the guidance of predicted risk factors. 2010;2279-0853.

Rashid T, Naheed A, Farooq U, Iqbal M, Barakat N. Conversion of laparoscopic cholecystectomy into open cholecystectomy: an experience in 300 cases. J Ayub Med College Abbottabad. 2016;28(1):116-9.

Agarwal S, Joshi AD. Perioperative complications of laparoscopic cholecystectomy: a cross-sectional observational study. Int Surg J. 2020;7(5):1490-5.

Simopoulos S. Botaitis. Risk factors for conversion of laparoscopic cholecystectomy to open cholecystectomy. Surg Endosc. 2005;19: 905-9.

Dalal AS, Sharma VI, Mathur RK. Study of factors for conversion of laparoscopic cholecystectomy to open cholecystectomy. Indian J Basic Applied Med Res. 2017;6(2):24-30.