CAUSES OF CONVERSION OF LAPROSCOPIC CHOLECYSTECTOMY TO OPEN CHOLECYSTECTOMY

Objective: To evaluate the possible risk factors responsible for the conversion of laparoscopic surgery to open cholecystectomy.

Study Design: Descriptive case series.

Location and Duration: In the West Surgical Ward of Mayo Hospital Lahore for one year duration from July 2017 to July 2018.

Methodology: We retrospectively evaluated the medical records of 305 patients with gallbladder disease. We studied all data of patients treated for inflammatory gallbladder disease to estimate the risk factors that force a surgeon to convert laparoscopy into open cholecystectomy.

Results: Of the 305 patients undergoing laparoscopic cholecystectomy, 20 (6.5%) required conversion to open surgery. The most common cause of transformation was intense adhesion in 10 cases, Uncontrolled bleeding in 3 cases; 2 of them are one of the cystic artery and gallbladder bed. Injury to biliary duct in 2 cases, intense and not separate able adherence in 2 cases, inability to identify the anatomy in 3 cases, in 1 case cholecysthoduodenal fistula and gallbladder in 3 cases were fall into the peritoneal cavity.

Conclusion: The conversion rate of the surgeon community has been decreasing due to the experience gained by the surgeon community over the last three decades.

Key Words: Laparoscopy, Cholecystectomy, Minimum Access Surgery.