Rate of conversion and complications of laparoscopic cholecystectomy in a tertiary care center in Saudi Arabia

Ghnnam, Wagih Mommtaz; Malek, Jawid; Shebl, Emad; Elbeshry, Turky Maeed; Ahmad, Irfan

doi:10.4103/0256-4947.60521

Cited by 30 publications

(35 citation statements)

References 20 publications

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“…This is comparable to the rates reported in other series. [8][9]26 The rate of conversion was higher in the male cohort (5% versus 4%). This difference, however, was not statistically significant.…”

Section: Discussionmentioning

confidence: 99%

Is the Male Gender an Independent Risk Factor for Complication in Patients Undergoing Laparoscopic Cholecystectomy for Acute Cholecystitis?

Ambe

Köhler²

2015

International Surgery

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This paper was designed to investigate the gender dependent risk of complication in patients undergoing laparoscopic cholecystectomy for acute cholecystitis. Laparoscopic cholecystectomy is the standard procedure for benign gallbladder disorders. The role of gender as an independent risk factor for complicated laparoscopic cholecystectomy remains unclear. A retrospective single-center analysis of laparoscopic cholecystectomies performed for acute cholecystitis over a 5-year period in a community hospital was performed. Within the period of examination, 1884 laparoscopic cholecystectomies were performed. The diagnosis was acute cholecystitis in 779 cases (462 female, 317 male). The male group was significantly older (P ¼ 0.001). Surgery lasted significantly longer in the male group (P ¼ 0.008). Conversion was done in 35 cases (4.5%). There was no significant difference in the rate of conversion between both groups. However the rate of conversion was significantly higher in male patients . 65 years (P ¼ 0.006). The length of postoperative hospital stay was significantly longer in the male group (P ¼ 0.007), in the group . 65 years (P ¼ 0.001) and following conversion to open surgery (P ¼ 0.001). The male gender was identified as an independent risk factor for prolonged laparoscopic cholecystectomy on multivariate analysis. The male gender could be an independent risk factor for complicated or challenging surgery in patients undergoing laparoscopic cholecystectomy for acute cholecystitis.

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Section: Discussionmentioning

confidence: 99%

Is the Male Gender an Independent Risk Factor for Complication in Patients Undergoing Laparoscopic Cholecystectomy for Acute Cholecystitis?

Ambe

Köhler²

2015

International Surgery

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“…7 A conversion rate of 11% in their cases, the most common cause of conversion being difficult anatomy. 8,9 Conversion from LC to open cholecystectomy was required in 5% in another study by Wagih et al 10 Several complications related to anesthesia, peritoneal access, pneumoperitoneum, surgical exploration, and thermocoagulation have been reported during LC, and these complications and several other factors can necessitate the conversion from LC to open cholecystectomy (OC). Although there are several studies reporting various rates of the causes of this worldwide medical problem, every institution must have a thorough understanding of the rate and causes of conversion to open surgery based on culture and geography, in addition to an understanding of conversion within the institution.…”

Section: Introductionmentioning

confidence: 99%

Factors resulting in conversion of laparoscopic cholecystectomy to open cholecystectomy-institution based study

Awan¹,

Hamid²,

Mir³

et al. 2017

Int Surg J

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Background: Laparoscopic surgery has revolutionized the way it is performed for an increasing number of patients. In this study, we determined the various reasons for conversion of laparoscopic cholecystectomy in our setup.Methods: This was a descriptive study, conducted at Government Medical College Srinagar, Frommay 2015 to June 2017. The study included 450patients with symptomatic cholelithiasis, who underwent laparoscopic cholecystectomy. All patients were operated by experienced laparoscopic surgeons with experience of more than 300 Laparoscopic cholecystectomies. Cases that required conversion from laparoscopic to open surgery were analyzed and the factors possible for such conversion were studied.Results: The mean age of patients was 45.6 years and male to female ratio 1:3.8. The mean operating time was 49 minutes and average hospital stay was 2 days. Out of 450 patients, 26(5.8%) required open conversion. Factors responsible for open conversion were dense adhesions in 12(2.7%), obscure anatomy at clot’s triangle in 6, (1.3%), significant intra-operative bleeding 5 (1.1), CBD injury 1(0.2%), visceral injury 1 (0.2%), and instrument failure in 1(0.2%) conversions.Conclusions: Open conversion rate of laparoscopic cholecystectomy in this study was 5.8%. The commonest cause of conversion was dense adhesions around the gall-bladder. Preventable factors like instrument failure or power breakdown can be addressed by a reliable back up.

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“…It is now considered as the treatment of choice for symptomatic gallstones and its advantages over open cholecystectomy (OC) are well known. [1][2][3][4] Risk factors accounting for the perioperative complications of LC has been of major interest. All literature agree that risk factors that could predict conversion are: acute cholecystitis, older age, male gender, obesity, and a thickened gallbladder wall.…”

Section: Introductionmentioning

confidence: 99%

Role of Male Gender in Laparoscopic Cholecystectomy Outcome

Alqahtani¹,

Ghnnam²,

Alqahtani³

et al. 2015

IJSM

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Background: Laparoscopic cholecystectomy is one of the most commonly performed laparoscopic procedures. Many problems occur during laparoscopic cholecystectomies like common bile duct injury, hemorrhage, and other complications. Some authors consider male gender as a risk factor for laparoscopic cholecystectomy conversion rate. Aims: To determine the effect of male gender on the outcome of laparoscopic cholecystectomy for Chronic Cholecystitis. Methods: A retrospective clinical trial was carried out at our Hospital to investigate male gender as a predictor for difficult laparoscopic cholecystectomy. All the operations were done according to our standard four-port technique. 1 Anesthetic technique and perioperative management were the same for all patients during the study period. Results: From a total number of 638 patients, who underwent laparoscopic cholecystectomy for Chronic Cholecystitis from 1st January 2012 to 1st of January 2015) 217 patients excluded according to exclusion criteria. The remaining 421 patients were included. We found that female patients were four times more than male patients, mean age was 40 years (range 13-101 years) for both genders. There were more statistically significant difficult laparoscopic cholecystectomies in males in comparison to female patients for chronic cholecystitis. Conclusion: Male gender is a statistically significant predictor for difficult laparoscopy for symptomatic gallstones presented as chronic cholecystitis

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Rate of conversion and complications of laparoscopic cholecystectomy in a tertiary care center in Saudi Arabia

Cited by 30 publications

References 20 publications

Is the Male Gender an Independent Risk Factor for Complication in Patients Undergoing Laparoscopic Cholecystectomy for Acute Cholecystitis?

Is the Male Gender an Independent Risk Factor for Complication in Patients Undergoing Laparoscopic Cholecystectomy for Acute Cholecystitis?

Factors resulting in conversion of laparoscopic cholecystectomy to open cholecystectomy-institution based study

Role of Male Gender in Laparoscopic Cholecystectomy Outcome

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