Publication:

A study of factors associated with conversion of laparoscopic cholecystectomy to open cholecystectomy

Background Gall stones are among the most common gastrointestinal illness requiring hospitalization. Laparoscopic cholecystectomy is the procedure of choice for majority of patients. Factors responsible for conversion to open cholecystectomy are adhesions, obscure anatomy at calot’s triangle, CBD injury etc. Aim was to study patients admitted in surgery department and undergoing laparoscopic cholecystectomy in GMCH, Udaipur. Primary objective was to determine factors of conversion of laparoscopic to open cholecystectomy in tertiary care center Secondary objectives were to evaluate the age, sex and etiological factors of cholelithiasis.

Methods It is a prospective observational study done in 1oo patients admitted in GMCH during January 2020 to June 2021 after informed consent and ethical clearance approval from IRRC. Patients having cholelithiasis were diagnosed with USG, MRCP and/ or ERCP and laparoscopic cholecystectomy was planned. Factors associated for conversion from laparoscopic to open cholecystectomy were studied.

Results Out of 100 patient 9 were converted to open, adhesion was the most common (8%), (2%) CBD injury, bleed of cystic artery, (1%) bowel injury, (3%) presence of unclear anatomy.

Conclusions Laparoscopic cholecystectomy is a safe and minimally invasive technique, with only low conversion rate and the commonest cause of conversion in this study was the presence of dense adhesions at Calot's triangle.