A Prospective Study: To Formulate a Scoring System for Prediction of Conversion from Laparoscopic Cholecystectomy to open Cholecystectomy

Abstract

Aim: Laparoscopic cholecystectomy (LC) has become the gold standard of treatment of gall bladder disease, but conversion to open cholecystectomy is still inevitable certain cases. The knowledge of the rate& impact of the causes for conversion could help the surgeon during preoperative assessment & inform the patients accordingly .In this study we review the causes and rate of conversion to open from laparoscopic cholecystectomy. Method and Materials: A total no. of 50 patients who were primarily posted for laparoscopic cholecystectomy, subsequently got converted to open cholecystectomy for various reasons were taken into the study. At the end of the study the various factors were assessed for the strength of association and a scoring system was formulated for prediction of conversion from LC to OC. Observation: The conversion rate is 8.34% in this study. T he commonest cause were dense adhesion (40%), and obscure anatomy at calot"s triangle (36%).Pre-operative high WBC count is also another cause leading to conversion. The no. of attacks with co-morbid conditions was also leads to conversion. This study includes twelve no. of parameters to formulate a scoring system to predict conversion from laparoscopic cholecystectomy to open cholecystectomy. Conclusion: A composite scoring system was formulated comprising detail history, USG findings, and laboratory values along with co-morbid conditions which when present would help us in predicting conversion from laparoscopic to open cholecystectomy in any given patient.