International Journal of Applied Research
Vol. 3, Issue 12, Part A (2017)
Conversion of laparoscopic cholecystectomy to open cholecystectomy: An analysis in a high risk group of patients
Background: Laparoscopic cholecystectomy (LC) has revolutionized minimally invasive surgery, considered as gold standard and increasing number of procedures are done for patients with various high risk comorbid conditions. LC today can be as straightforward operation, but may also be an operative approach fraught with underlying complexities necessitating conversion to open cholecystectomy leading to longer operative time, longer hospital stay and more postoperative morbidity and higher hospital costs. We have tried to estimate the rate and risk factors which are associated with the conversion. Materials and Methods: In this prospective and retrospective hospital based observational study, we included 134 patients that underwent LC and laparoscopy converted to open cholecystectomy from May 2012 to May 2016. Patient records were analyzed and their demographic, physical and clinical examination details were taken into account. Results: 134 patients were enrolled for LC, 12 patients (8.9%) converted to open cholecystectomy. In conversion group ASA III and ASA IV categories predominate with ASA IV constituted about (66.7%) of patients. Patients in age group 40-60 years dominated study. Coronary artery disease (CAD) with stent in (8.3%) and (16.7%) patients having CAD with previous surgical intervention as coronary artery bypass surgery (CABG) were present in converted group. Most common reason for conversion were adhesion in calot’s triangle in 9/12 (75%) of patients. Increase in operative time by more than 30 minutes, postoperative complication by 25% and total hospital stay by 24hours as compared to LC group. Conclusions: A thorough review of all the risk factors if performed based on the physical, clinical, comorbid status and intraoperative findings helps the surgeon in proper patient counselling and early conversion to open cholecystectomy for patient safety.
How to cite this article:
Dr. GH Hussain Mir, Sajad Ahmad Bhat, Talib Khan, Muneer Ahmad Want, Ajaz Ahmad Mailk, Khursheed Alam Wani, Tariq Ahmad Mir, Mir Nadeen. Conversion of laparoscopic cholecystectomy to open cholecystectomy: An analysis in a high risk group of patients. Int J Appl Res 2017;3(12):46-49.