Author : A, Kumble Ananth Prabhu, Yateesh H M, Basil Ibrahim, Ajmal.
Study of preoperative factors as predictors in failed laparoscopic cholecystectomy requiring conversion to open cholecystectomy at a tertiary hospital
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 3, Pages 1257-1262
Background: Laparoscopic cholecystectomy is considered the treatment of choice for symptomatic Cholelithiasis. However, of all Laparoscopic cholecystectomies, 1-13% requires conversion to an open for various reasons. Present study was aimed to Study various preoperative factors as predictors of laparoscopic cholecystectomies required conversion to open route at our tertiary hospital.
Material And Methods: Present study was case record based, retrospective study, conducted among case records of patients who required conversion to open cholecystectomy from laparoscopic cholecystectomy was done.
Results: In present study, among 530 laparoscopic cholecystectomy (LC) procedures, 42 cases required conversion to open cholecystectomy (OC) and conversion rate was 7.92 %. In cases required conversion, indication for cholecystectomy were recent acute cholecystitis (40.48 %), recent obstructive jaundice (21.43%) and impacted stone (16.67 %). In cases required conversion, common intraoperative events observed were significant bleeding (47.62%), fibrosis (35.71%), dense adhesions at calot’s triangle (30.95%) and difficult port entry (26.19%). On analysis of preoperative risk factors age >50 years, Male gender, previous history of hospitalisation due to acute cholecystitis, Palpable gallbladder, BMI > 30 kg/m2, history of previous laparotomy, USG findings of thick-walled GB (>4mm), and Pericholecystic collection were related to failed laparoscopic cholecystectomy surgery required conversion to open procedure.
Conclusion: Age >50 years, Male sex, previous history of hospitalisation due to acute cholecystitis, Palpable gallbladder, BMI > 30 kg/m2, history of previous laparotomy, USG findings of thick-walled GB (>4mm), and Pericholecystic collection were found to be significant pre-operative predictive factors in laparoscopic cholecystectomies required conversion to abdominal route.