Study on the Conversion of Laparoscopic Cholecystectomy Owing to per Operative Complications

Abstract

Background: Laparoscopic surgery has advanced to the point that it is being performed even for malignant conditionsin the current healthcare era. Conversion to open technique is a major morbidity of laparoscopy as it loses its supremacyover open technique once the conversion takes place.Objectives: To study the Conversion of Laparoscopic Cholecystectomy owing to per operative complications.Methods: There were a total of 100 patients that matched the criteria for inclusion. A comprehensive medical historywas obtained, as well as a detailed medical examination was done. Blood tests were performed as part of the admissionsprocess. All of the patients underwent a liver function test. Ultrasonography of the abdomen and upper GI endoscopywere done on all patients. Patients with suspected pancreatic/common bile duct pathology underwent CECT abdomen.Patients with increased alkaline phosphatase and dilated CBD/associated CBD pathology underwent MRCP. In all cases,consent was obtained for conversion if necessary.Results: Out of 100 cases, 13 cases were converted to open cholecystectomy. In majority of the cases, dense adhesion wasthe reason for conversion of laparoscopic cholecystectomy to open cholecystectomy in 38.46%. Arterial injury and difficultanatomy around calout’s was the reason for conversion in 23% of the cases each. Hepato biliary injury and technicaldifficulty was the reason for conversion in 7.69% of the cases each.Conclusion: Recognizing when a patient is at higher risk for conversion can help with preoperative counsellingand resource allocation in the operating room, can improve safety by limiting the time it takes to convert to an opencholecystectomy, and can identify patients who would benefit from a planned open approach.