Study of risk factors for conversion during laparoscopic cholecystectomy in a tertiary care teaching hospital

Abstract

Laparoscopic cholecystectomy has become the standard treatment for symptomatic gall bladder disease. However, there still a substantial proportion of patients in whom Laparoscopic cholecystectomy cannot be successfully performed, and for whom conversion to open surgery is required. This was a longitudinal study conducted in surgical unit of Sri Siddhartha Medical College. All the patients who had right hypochondriac pain and diagnosed with cholelithiasis on USG were included in the study. From the data collected, only factors available to surgeon preoperatively were considered for analysis. These factors included: age, gender, history of acute Cholecystitis, obesity and concomitant disease, In our study 90 patients were underwent laparoscopic cholecystectomy Out of 90 total patients included in the study 81 patients had underwent successful Laparoscopic cholecystectomy and 9 patients needed conversion to open cholecystectomy. The conversion rate is 10% which is consistent with the other studies. The most common reason for conversion was difficult to define anatomy in patients with inflamed, contracted gall bladder. Significant predictor factors for conversion were male gender, acute Cholecystitis, and obesity. In our study it is concluded that Male sex, Age >50yrs, obesity (BMI>35 kg/m2), and cholecystitis are considered risk factors for conversion of Laparoscopic cholecystectomy to Open cholecystectomy. These factors can predict difficulty to be encountered during surgery and help in making a decision for conversion thus shortening the duration of surgery and preventing unnecessary complications.