CHOLECYSTECTOMY;

REASONS AND RATES IN CONVERSION FROM LAPAROSCOPIC TO OPEN CHOLECYSTECTOMY

Abstract

Introduction: Gallstones patients are mostly asymptomatic, but yet, it adds
considerable burden to health care system as only in United States more than 600000
laparoscopic cholecystectomies are performed annually. The introduction of day care with
laparoscopic (LC) surgery in the late 1980s increased the rate of cholecystectomy for about
20%. This new intervention introduced changes in indications of cholecystectomy and put
further impact on health care system. After the introduction of LC, many studies have highlighted
and discussed the importance of adequate surgical skills in order to improve the timing and
outcome of surgery. The aim of this study was to see the conversion from laparoscopic to open
surgery in symptomatic patients. Study Design: Descriptive Cross Sectional Study. Period:
January 2013 to 2015. Setting: Surgical unit I of Peoples Medical College Hospital Nawabshah.
Methods: Study population consists of two hundred cases having non probability consecutive
patients of cholelithiasis who were eligible on inclusion criteria. Results: The conversion rate
was 10 %, seven (3.5%) patients had biliary injury, six (3%) had adhesions, four (2%) patient
had vascular injury, two (1%) patients had gut injury, one (0.5%) patient had dilated common
bile duct. Conclusion: Proper pre-operative assessment and proper anatomical recognition of
Calot’s triangle reduce the rates in conversion from laparoscopic to open surgery.