TITLE:
Conversion Rate of Laparoscopic Cholecystectomy to Open Surgery at Al Karamah Teaching Hospital, Iraq
AUTHORS:
Basim Jasim Abdulhussein, Yarub Fadhil Hussein, Abdulsalam Hatem Nawar, Redhwan Ahmed Al-Naggar
KEYWORDS:
Gall Bladder, Laparoscopy, Cholecystectomy, Open Surgery
JOURNAL NAME:
Surgical Science,
Vol.6 No.5,
May
26,
2015
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.