Conversion of Laparoscopic to open cholecystectomy - six years experience at Shalamar Hospital, Lahore

Abstract

Background: Laparoscopic Cholecystectomy (LC) is the gold standard treatment for symptomatic Gall Stones. The identification of factors that reliably predict the likely need to convert LC to open procedure would decrease the incidence of intraoperative complications and help in patient counseling about LC before surgery. Methods: Between 2001 and 2006, 300 elective Laparoscopic cholecystectomies were performed from a total of 470 elective cholecystectomies. The change in conversion rate between 200 1 to2003 and 2004 to 2006 was analysed. Factors predictive of higher risk for conversion were also identified. Results: Twelve LCs (4.0%) required conversion. History of acute attack for more than 72hrs was a strong predictor of conversion even if patient has minimal signs and symptoms. The conversion rate from 2001 to 2006 was only slightly changed i.e.; it has decreased for last 3 years. Conclusion: The conversion rate over the last 6 years has decreased with no incidence of intraoperative complications. Age >= 50 years, male patients and acute cholecystitis are the major predictors of conversion.