Laparoscopic cholecystectomy?Can conversion be predicted?

Abstract

The possibility of conversion to open cholecystectomy (OC) always exists while performing a laparoscopic cholecystectomy (LC). This study has been performed with the aim of identifying factors predicting conversion to OC. From October 1992-April 1994, LC was attempted in 150 patients and conversion to OC was required in 29 (19%) patients. Ten preoperative factors were analyzed retrospectively to identify parameters significantly correlating with conversion to OC. Preoperative factors analyzed were age, sex, duration of symptoms, BMI (Body Mass Index), past history of jaundice, previous abdominal surgery, associated medical risk factors, palpable lump on clinical examination, USG, and OCG findings. Univariate and multiple stepwise regression analysis identified male sex, USG finding of contracted/thick-walled gall bladder, and a palpable gall bladder lump on examination as significant preoperative factors predicting conversion to OC.

Pre and per operative prediction of difficult laparoscopic cholecystectomy using clinical and ultrasonographic parameters

“…12,13 In this study 68% had BMI≤30, and 32% patients were having BMI>30, but there was no significant difference in obese patients with regard to conversion rates and operative time (p>0.05).The reason for higher conversion rates in male patients remains unexplained, though male gender has been a significant risk factor in most series. 8,14 It has been observed that male patients have more intense inflammation or fibrosis, resulting in more difficult dissection both in the triangle of Calot's and through the plane between the GB and the liver. In our study we encountered difficulty in access in four patients.…”

Evaluation of power Doppler sonography in acute cholecystitis to predict intraoperative findings: Prospective clinical study

“…Various conversion rates have been reported in the literature, ranging from 4.9% to 29%. [12][13][14] With limited number of patients, our conversion rates were 2.1% and 3%, in chronic and acute cholecystitis, respectively. Although there were high conversion rates in some studies, recent and large reports have shown marked decrease over time.…”

Laparoscopic Cholecystectomy: What is the Price of Conversion?

“…As expected, patients in the CONV group were older and more frequently male, which are reported risk factors for conversion. [15][16][17][18][19][22][23][24][25][26][27][28][29][30][31][32][33] The CONV group also had greater preoperative ASA scores and some comorbidities, such as hypertension (Table II). We corrected for these differences by using a multivariate analysis.…”