Indicators for conversion from laparoscopic to open cholecystectomy. A clinical study.

Abstract

ABSTRACT… Objective: To determine the reason that why laparoscopic cholecystectomy should be shifted to open surgery. Study Design: Retrospective study. Setting: Department of General Surgery, LRH, Peshawar. Period: January 1, 2018 and December 31, 2021. Material & Methods: The study included 256 people who were scheduled for laparoscopy but later switched to laparotomy, while the remaining 258 patients who did not switch were included in the control group. They were divided into two groups using sealed opaque envelopes with randomly generated computer numbers. Variables considered for switching included anatomical abnormalities, gender, age, acute and chronic cholecystitis, inflammatory infiltration, peritoneal adhesions, cardiac disease, hypertension, neurological disorders, diabetes, and other medical conditions of the patient. Variables were compared using the chi-square test with a statistical significance level of 5%. Odds ratios (OR) and 95% confidence intervals (CIs) were calculated. Results: The mean age of the intervention group was 64 years, compared to 54 years for the control group. There was highly significant difference between the two groups regarding age, gender, anatomical abnormalities, acute and chronic cholecystitis, inflammatory infiltration, cardiac disease, hypertension, neurological disorders conversion variable from laparoscopy to laparotomy. Conclusion: Proper treatment planning and consideration of studied variable before decision of the choosing the procedure is required.