Risk factors influencing conversion of laparoscopic cholecystectomy to open cholecystectomy

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.

Intra-operative factors responsible for conversion of laparoscopic cholecystectomy to open cholecystectomy in a tertiary care center

“…Thyagarajan et al and Mukherjee et al11,13,14 Mean age of patients in present study was found to be 41.29 years which is comparable to the studies by Tariq et al, Singh et al and Mukherjee et al11,12,14 Maximum cases were in the age range of 41-50 years. Maximum rate of conversion i.e.…”

Gall Bladder Wall Thickness: Sonographic Accuracy and Laparoscopic Cholecystectomy Conversion Rate, Evaluated by Histopathology

“…In this study, we found that increase GB wall thickness on preoperative ultrasound which encountered in 39 patients out of 110 patients (35.5%) were associated with increase operative difficulty in 18 patients out of 39 patients, and our conversion rate to open surgery in six patients out of 110 patients (5.5%) was within the range reported by several other studies (1 -10%) as in Indian one conducted in 2017 with a report of conversion rate of 10% (16) , in USA in 2010 were the rate was 9% (17) , and a local study in Iraq in 2007 (18) where the rate was 5%. In this study, GB wall thickness significantly determines the difficulty during surgery.…”

Predicting difficult laparoscopic cholecystectomy

“…This finding is supported by Thyagarajan M et al They found a conversion rate of as high as 34% in cases with history of previous attacks of acute cholecystitis. 20 Liu et al and Khetan A also reported previous history of acte cholecystitis as a significant predictor of difficult LC. 21,22 Acute cholecystitis may lead to increased gall bladder wall thickness and cause scarring and fibrosis in and around gall bladder, making subsequent surgery difficult.…”