Laparoscopic Cholecystectomy; Is Conversion Really a Complication- A Prospective Study to Evaluate Complications and Conversion Rates

Abstract

BACKGROUND In this era of advanced surgical approaches, Laparoscopic Cholecystectomy is the procedure of choice for gall bladder diseases. But fear of conversion to open cholecystectomy is really a night mare among surgeons and patients. Good counselling and better predictability can avert the misconception of conversion as a complication of it. This study was conducted with an aim to evaluate complications as well as conversion rates in normal and high risks patients. MATERIALS AND METHODS The study included all adult subjects who have definite clinical, biochemical and radiological indications for laparoscopic cholecystectomy. After clearance from the ethical committee, we also included those patients in whom laparoscopic cholecystectomy was previously not frequently performed like acute cholecystitis, chronic cholecystitis, history of previous upper abdominal surgeries, and in obese patients with BMI>30. Definitely benefits outweigh risks in these patients. Statistical analysis was done by using chi square test, Fisher's exact test with the help of SPSS version 20. RESULTS We have observed that out of 67 subjects, n=22, 32.8% were between 31-40 years of age, n=43, 64.1% were females and n=24, 35.8% were males. Commonest complaint is abdominal pain present in n=43, 64.2%. Cholelithiasis was the most common indication present in n=52, 82% patients. Out of 67 patients, n=6, 8.9% had history of upper abdominal surgeries, acute cholecystitis present in n=9, 13.4%, chronic cholecystitis in n=3, 4.4% and n=2, 2.9% had BMI >30 kg/m 2. Total conversion rate was n=8, 11.9% which was slightly high as we have included high risk patients also. But still we have avoided conversion in total n=4, 66.6% with upper abdominal surgeries, n=2, 66.6% patients with chronic cholecystitis, n= 4,100% in acute cholecystitis of pain duration<72 hours and n=2,100% obese patients. Although p-value calculated by chi square test was found to be 0.3126 [>0.05]. CONCLUSION Definitely, conversion should never be considered as a complication of laparoscopic cholecystectomy and there is no question that laparoscopic cholecystectomy is the gold standard for gallbladder diseases.