Conversion of Laparoscopic Cholecystectomy to Open Cholecystectomy: An Analysis in a High Risk Group of Patients

Mir, Gh Hussain; Bhat, Sajad Ahmad; Khan, Talib; Wani, Mohammed Afzal; Mailk, Ajaz Ahmad; Wani, Khursheed Alam; Mir, Tariq Ahmad

doi:10.21767/2254-6758.100087

Cited by 5 publications

(14 citation statements)

References 12 publications

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“…Since the introduction of laparoscopic cholecystectomy (LC), it rapidly gained popularity, almost replacing open cholecystectomy in many countries, [1][2][3][4][5] and several studies showed that LC can be successfully introduced in developing and low-income countries, with satisfactory results. [3,[6][7][8][9][10][15][16][17], However, in Afghanistan, despite the fact that LC was introduced more than a decade ago, most cholecystectomies are done through an open approach, due to limited equipment, support services and manpower required for LC. [16,21] Mean age was 45.8 ± 13.5 years, where most of the patients were in 31-50-and 51-70-year age groups.…”

Section: Discussionmentioning

confidence: 99%

“…[11][12][13][14] Conversion rate to open cholecystectomy is variable and has been reported from 1.9-14.7%. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] It is noteworthy that the data regarding safety of day care LC came from developed countries with wellestablished norms for day care surgery, and should not be extrapolated to surgical practice everywhere. [8] However, several studies show that LC can be successfully introduced in developing and low-income countries, with satisfactory results.…”

Section: Introductionmentioning

confidence: 99%

“…[8] However, several studies show that LC can be successfully introduced in developing and low-income countries, with satisfactory results. [3,[6][7][8][9][10][15][16][17] Mehraj et al suggested that proper training, case selection, technique and visual equipment were the key factors to ensure good results. [7] In a comparative study, Brekalo et al showed that it was possible to achieve satisfactory results in a poorly developed country with little resources, and that the human factor played a major role.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Laparoscopic Cholecystectomy: Review of 1430 Cases in Cure International Hospital, Kabul, Afghanistan

Farda

Tani²,

Manning³

et al. 2021

Preprint

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BackgroundLaparoscopic Cholecystectomy (LC) is the gold standard for the treatment of cholelithiasis in most countries of the world. The objective of this study was to evaluate the outcomes of LC in the surgery department of Cure International Hospital, Kabul, Afghanistan. MethodsA retrospective study was conducted on 1430 LC cases performed by the general surgery department of Cure International hospital. Data was collected from patient files and the operation theatre registry for whom LC was performed during January 2008 through December, 2019. ResultsMean age was 45.77±13.45 years (14-90 years), with male/female ratio of 1:4.7. One third (33%) had comorbidities. Most of patients (~97%) were classified as ASA grade I and II. Of all patients, 26.8% of males and 13.2% of females had gallbladder inflammation (OR=2.203, 95%CI 1.56 – 2.61, P=0.000). Overall mean duration of anesthesia was 75±25.6 minutes. The conversion rate to OC was 4.6% (N=66), most commonly dense adhesions at Callot’s triangle (3.8%). The intraoperative complication rate was 17.5% (N=249), where bile/stone spillage was the most common indication (N=235, 16.4%). Immediate postoperative complication rate was 2.4% (N=35). Average length of stay (ALOS) after LC was 2.23±1.43 days (1-19 days).ConclusionThis study shows that elective LC can be performed safely in Afghanistan with comparable outcomes in terms of complications, conversion rates, and ALOS to other countries of the region and the world. Proper case selection and careful preoperative evaluation and management can decrease further conversion, intra- and postoperative complications.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Laparoscopic Cholecystectomy: Review of 1430 Cases in Cure International Hospital, Kabul, Afghanistan

Farda

Tani²,

Manning³

et al. 2021

Preprint

View full text Add to dashboard Cite

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“…A study from a single university medical center recorded a 2.6 percent conversion rate, and among converted cases, the diagnosis of acute cholecystitis was more frequent. 2 (3.3 %) laparoscopic procedures involved conversion to open surgery due to blurred vision due to difficult dissection and bleeding in the current study [20][21][22] 23 . Many prospective randomized trials have shown that early laparoscopic cholecystectomy avoids possible risk of late complications such as gangrenous or emphysematous cholecystitis & is the preferred technique for treating the acutely inflamed gallbladder within 7 days of the onset of symptoms without a rise in postoperative morbidity and mortality.…”

Section: Discussionmentioning

confidence: 99%

A Comparative Analysis between Laparoscopic and Open Cholecystectomy at a Tertiary Care Hospital in Patients with Acute Cholecystitis

2021

IJFMT

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Background: Acute cholecystitis is clinically characterized as an episode of acute biliary pain; fever and right hypochondrial tenderness with symptoms persistence exceeding 24 hours. Aims & Objectives: We compared and analyzed open and laparoscopic cholecystectomy in the current study on the basis of the duration of the operation, intra and postoperative complications and the length of hospital stay & return to work. Material and Methods: This was a prospective comparative, randomized hospital-based study performed in patients of 20 -80 years of age with acute cholecystitis in the Department of General Surgery from July 2019 to January 2021 at SMH&RC, Datta Meghe Medical College Nagpur. Patients were divided randomly into two classes as Open cholecystectomy (60 patients) and laparoscopic cholecystectomy (60 patients). The key assessed outcome was death, peri-operative & post-operative complications; length of hospital stay and wound infection, return to work. The gathered data was statistically analyzed.Results: In both categories, the most common age group was 40-59 years old. The female population (78%) was greater than the male population (22 percent). 1: 3.6 was the male to female ratio. The mean time needed for open cholecystectomy was 53.18 ± 12.74 minutes, while 38.37 ± 6.21 minutes for laparoscopic cholecystectomy, and the difference was statistically important. 2 (3.3 percent) laparoscopic procedures involved conversion to open surgery due to difficult dissection, bleeding & blurred vision. In terms of postoperative pain (VAS > 4), hospital stay period and return to work, laparoscopic cholecystectomy had better outcomes than open cholecystectomy and the difference was statistically important. In Open Cholecystectomy patients, wound infection, post-operative paralytic ileus was substantially greater. There were 2 patients with wound dehiscence from open cholecystectomy. No significant morbidity or any mortality during the study period was reported. Conclusion:Laparoscopic cholecystectomy provides decisive advantages over open cholecystectomy in acute cholecystitis (e.g. shorter time of surgery, fewer post-operative complications, less paralytic ileus, less analgesic use, early discharge and mobilization).

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“…Conversion to open surgery from laparoscopic cholecystectomy was encountered because of recurrent management of multiple episodes of acute cholecystitis and avoiding definitive surgery because of associated comorbidities. The conversion decision is considered as a sound judgment to avoid complications and reduce morbidity (Hussain et al 2017).…”

Section: Discussionmentioning

confidence: 99%

Cholecystectomy for Gallstone: Types and Findings

2020

JHMN

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Gall stone disease remains a common and significant cause of suffering in most parts of the world. Gallstones are the most common biliary pathology. A descriptive study covered 80 patients underwent surgical treatment for gallstone diseases. Ultrasound study and plain abdominal X-ray were done to confirm the presence of gallstone. More than half of the sample 58.8% were in the oldest age group 50-69 year. Female were 68(85%) and the remaining 12(15%) patients were male. Most of patients 60(75.0%) operated upon by open cholecystectomy, laparoscope used in 18(22.5%). The main finding on exploring the abdomen was inflammatory adhesion in 54(67.5%) of the patients, thick wall gallbladder came next in 12 (15%) patients. Many complications and clinical findings associated with gallstone, some of them are serious other are even fatal. That is why cholecystectomy is highly indicated even for silent gallstone.

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Conversion of Laparoscopic Cholecystectomy to Open Cholecystectomy: An Analysis in a High Risk Group of Patients

Cited by 5 publications

References 12 publications

Laparoscopic Cholecystectomy: Review of 1430 Cases in Cure International Hospital, Kabul, Afghanistan

Laparoscopic Cholecystectomy: Review of 1430 Cases in Cure International Hospital, Kabul, Afghanistan

A Comparative Analysis between Laparoscopic and Open Cholecystectomy at a Tertiary Care Hospital in Patients with Acute Cholecystitis

Cholecystectomy for Gallstone: Types and Findings

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