Prospective study of predictive factors for conversion of laparoscopic cholecystectomy to open surgery

Abstract

Background: Gallstone diseases are a common gastrointestinal illness in the general population that frequently requires hospitalization with a prevalence of around 11% to 36% The goal of this study was to determine the conversion rate and identify the factors responsible for the conversion of laparoscopic cholecystectomy (LC) to open cholecystectomy (OC).This study intends to evaluate the causes of conversion from LC to OC and to establish the efficacy and safety of the procedure. Methods: This case series was conducted in the department of general surgery at Gujarat Adani institute of medical science, Bhuj, Gujarat from October 2018 to July 2020. Patients more than 18 years of age presenting with OPD with symptomatic gallstones and patients with acalculous cholecystitis were included in the study. Patients with dilated CBD (>8 mm in diameter), jaundice, gallbladder malignancy, and perforated gallbladder were excluded. Results: A total of 100 patients were included in the study; 68 were females and 32 were males. Eleven (11%) patients were converted to OC. The most common cause of conversion was dense adhesions followed by obscure anatomy at Calot's triangle. Other common causes were bleeding, bile leakage, visceral injuries, and instrument failure Conclusions: Most common cause of conversion from LC to OC was dense adhesions causing obscure anatomy at Calot's triangle followed by bleeding and CBD injury.