Conversion Rate of Laparoscopic Cholecystectomy to Open Surgery at Al Karamah Teaching Hospital, Iraq

Abstract

Background: Laparoscopic cholecystectomy has become the standard treatment for symptomatic gall bladder disease. However, there still a substantial proportion of patients in whom Laparoscopic cholecystectomy cannot be successfully performed, and for whom conversion to open surgery is required. Method: In this study, 1600 laparoscopic cholecystectomy performed at Al karamah teaching hospital from January 2010 to January 2015, were prospectively analyzed. The patients studied included 1600, 1245 where females (78.4%) and 346 where males (21.6%) with a mean age of 41.2 years. From the data collected, only factors available to surgeon preoperatively were considered for analysis. These factors included: age, gender, history of acute Cholecystitis, jaundice, previous abdominal surgery, obesity and concomitant disease, ultrasound preoperatively & ERCP. Results: Of the 1600 patients in whom Laparoscopic cholecystectomy was attempted 56 patients (3.5%) required conversion to open surgery. The most common reason for conversion was difficult to define anatomy in patients with inflamed, contracted gall bladder (n = 42). Significant predictor factors for conversion were male gender, previous abdominal surgery, acute Cholecystitis, and obesity. Conclusion: An appreciation for these predictors for conversion will allow appropriate planning by the patient, the institution and the surgeon.

Laparoscopic Cholecystectomy, A single Surgeon experience at Teaching Hospital Biratnagar, Nepal

“…So, here our experience and results of LC is being shared and compared with other published reports of LC. In the present study, laparoscopic cholecystectomy was perfomed in 333 (82.58%) female, which is little bit higher but comparable with other study in which the incidence was 78.4% [4]. Age range of patients varied between 12-84 years with maximum patients in the age groups of 31-40 years which is comparable to Shrestha et al which also showed the maximum patients in age group 30-39 years [5].…”

“…Sakpal et al, Livingstone et al and Abdul Hussain was found to be 4.9%, 5-10% and 3.5% respectively[4,11,12]. The incidence is found to be low reason might be the growing experience of surgeons.…”

Preoperative Prediction of Difficult Laparoscopic Cholecystectomy: In Zagazig University Hospitals

“…History of jaundice was not found to had any predictive significance for difficult access to peritoneal cavity, dense adhesions at calot's triangle, dissection of the gall bladder bed or difficult extraction (p = 0.236, 0.521, 0.41, 0.652 respectively) as published by Ahmed et al in 2014 but Abdulhussein et al (2015) found that history of jaundice was significant predictive factor(p= <0.001) associated with conversion to open cholecystectomy. In our series it was not significant predictive factor for LC as we found that 22 patients had history of jaundice; 13 patients of them had difficulties others 9 patient had easy LC (P =0.5).…”

Personal experience with perforation of gallbladder during laparoscopic cholecystectomy

“…In the line of other studies [1][2][3][4][5][6][7] , thick wall of gallbladder, dense adhesions and over distended gallbladder were accompanied perforation of gallbladder.…”