Pre-operative and Intra-operative Predictive Factors for Conversion of Laparoscopic Cholecystectomy, Wad Madani Teaching Hospital, Gezira State, Sudan; (September 2020 - June 2021)

Abstract

Background: Laparoscopic cholecystectomy is gold standard for cholecystectomy. Objective: to determine pre- and intra-operative predictive factors for conversion of laparoscopic cholecystectomy to open. Methods: It was a comparative cross-sectional study performed in Wad Madani Teaching Hospital. Total coverage of patients (268 participants) admitted for elective laparoscopic cholecystectomy during (September 2020 - June 2021). Dependent variable: open cholecystectomy; independent: socio-demographical characteristics, co-morbid illnesses, body mass index, drug and surgical history; ultrasound and intra-operative findings. Master sheet, SPSS version 25.0 and Chi square test was used. P ≤ 0.05 was considered statistically significant. Results: Fifty six percent in age group (40-60 years); 87.3% females; 64.3% had normal body mass index; and 53% had history of abdominal surgery. Ultrasound findings: gall bladder wall thickness ≥4 in 91% and wasn’t fibrosed in 63.6%. Intra-operative findings: gall bladder contracted in 54.5%, Twenty-two cases converted to open; 72.3% of them in age group (40-60 years); and 72.3% were female. No statistical association between (socio-demographic characteristics; co-morbid diseases and number of admissions) and conversion of laparoscopic cholecystectomy to open. Regarding ultrasound findings: gall bladder wall thickness < 4 had significant statistical association with laparoscopic cholecystectomy; apart from that there was no significant statistical association with any ultrasound findings and that of both laparoscopic and open cholecystectomy. For intra-operative findings there was statistical association between contracted gall bladder and conversion of laparoscopic cholecystectomy to open surgery. Conclusion: contracted gall bladder is the main factor for conversion of laparoscopic cholecystectomy to open surgery.