A Clinical Prospective Study to Determine the Role of Conversion and Identify the Factors Responsible for Conversion of Laparoscopic Cholecystectomy to Open Cholecystectomy at Newly Established Tertiary Care Center
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 7, Pages 10006-10012
Abstract
Background: Laparoscopic cholecystectomy is the procedure of choice for the majority of patients with gall bladder disease. Conversion to open technique is considered a major morbidity of laparoscopic cholecystectomy as it loses its supremacy over open technique once the conversion takes place. This study was conducted in an effort to determine the conversion rate and also identify the factors responsible for conversion of laparoscopic cholecystectomy to open cholecystectomy.Materials & Methods: A clinical prospective study done on 50 patients presenting with cholelithiasis without choledocholithiasis; and with no contraindication for general anaesthesia were included in the study. Data recorded included demographic information, past medical history, indication for operation, duration of operation, reason for conversion and post-operative complications.
Results: The mean age in this study was 42.8 years. The sex distribution shows that the gall bladder diseases have a higher frequency in female than in males. Out of 50 patients, 35 patients (70%) had a chief complaint of pain in the right hypochondrium, 16 patients presented with epigastric pain. 8% of patients suffered from Diabetes mellitus whereas 6% of patients were Hypertensive. The average duration of surgery was 80.5 min. Average duration of post-op stay in successful cases was 4.2 days and in converted cases it was 6.3 days. A total laparoscopic surgery performed in 50 cases, out of which 10% cases converted to open cholecystectomy due to anatomic difficulty such as dense adhesion of calot’s triangle and anatomic variations (60%), bleeding from calot’s triangle (20%) and common bile duct injury (20%).
Conclusion: We conclude that laparoscopic cholecystectomy is a safe and minimally invasive technique, with only low conversion rate and the commonest cause of conversion in this study was the presence of dense adhesions at Calot's triangle.
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