Conversion from Laparoscopic to Open Cholecystectomy
Introductions: With the advent of newer technology, the era of open surgeryÂ for gall bladder diseases has been preferably taken over by laparoscopicÂ cholecystectomy. However, certain cases still require conversion to openÂ surgery. In this review we aim to analyze the reason for conversion.
Methods: This retrospective study was conducted at Patan Hospital, PatanÂ Acdemy of Health Sciences, Nepal. All patients who underwent laparoscopicÂ cholecystectomy from February 2009 to July 2012 were included in the study.Â File numbers of all the patients were obtained from operation room register.Â The patient files were analyzed for age, sex, duration of symptoms, liverÂ function tests, ultrasound findings and the description in operation note forÂ reason for conversion.
Results: The age ranged from 12 to 81 years with mean age of patients 32.76Â years and male to female ratio 1:2.9. The mean operating time was 65 minutesÂ and average post operative hospital stay was 1.61 days. Out of 305 patients, 34Â (11.14%) required open conversion. Factors esponsible for open conversionÂ were dense fibrosis at Calots in 11 (3.6%), adhesions due to previous abdominalÂ surgery in 6 (1.9%), uncontrollable bleeding in 5 (1.6%), bile duct injury in 4Â (1.3%) cholecystoenteric fistula in 3 (0.9%), Mirizziâ€™s syndrome 2(0.6%).
Conclusions: Adhesions at the calotâ€™s triangle was the common reason forÂ conversion from laparoscopic to open cholecystectomy.
Keywords: adhesions, conversion, gallstone, laparoscopic cholecystectomy