A RETROSPECTIVE ANALYSIS OF INCIDENCE OF TRANSFORMATION OF LAPROSCOPIC CHOLECYSTECTOMY INTO OPEN CHOLECYSTECTOMY

Objective: To analyze the incidence of intraoperative risk factors responsible for the transformation of laparoscopic cholecystectomy into open cholecystectomy in our environment.

Study design: A retrospective analytical study.

Place and Duration: In the Surgical Department of Benazir Bhutto Hospital Rawalpindi for one year duration from September 2017 to September 2018.

Methods: All patients who underwent laparoscopic cholecystectomy (n-283) and underwent open surgery (n = 10) were included. The reasons behind the transformation and the factors leading to it were recorded.

Results: A retrospective analysis of 283 patients with ages ranging from 25 to 65 years with M: F, 2: 8 and body weight between 45 and 95 kilograms was analyzed. Ten out of two hundred and eighty-three (283) patients had to be converted into open cholecystectomy due to reasons such as visceral adhesions or dense omntal - 2 (0.7%), mirizi syndrome - 2 (0.7%), and intrahepatic thick gall bladder2 (0.7%), gallbladder carcinoma 1 (0.4%), gallbladder empyema 1 (0.4%), gallbladder 1 (0.4%), cirrhosis liver 1, (0.4%), perforated gall bladder 1 (0.4%) . The success rate of cholecystectomy was 96.5% (273 of 283 cases), and the conversion rate to open type was 3.5% (10 out of 283 cases).

Conclusion: The etiology responsible for the transformation of LC into OC is multifactorial, but adequate preoperative evaluation, good skills and laparoscopic surgical team, adequate experience and innovations are important factors in achieving successful laparoscopic cholecystectomy.

Key words: Open cholecystectomy, laparoscopic cholecystectomy, conversion rate, risk factors.