Publication:

Risk factors for open conversion of laparoscopic biliary surgery

Background Conversion rates of laparoscopic to open biliary procedures vary according to different factors such as clinical presentation, co-morbidity, surgical experience and equipment.

Methods A prospective analysis of 464 laparoscopic cholecystectomies (LC) including 88 laparoscopic common bile duct explorations (LCBDE) over a period of 5 years was carried out in Menofia University Hospitals, between December 2012 to December 2017.

Results The male to female ratio in the series was 1:3.4 with a Median±SD age 51±16 years.  158 cases (34%) of all patients were admitted as an emergency including jaundice in 60 cases (13%), acute pancreatitis in 27 cases 6% and acute cholecystitis/empyema in 27 cases (6%). 153 cases (33%) had previous abdominal surgery. LCBDE was done in 88 cases. open conversion was necessary in 6/464 cases (1.3%) over 5 years; with no conversions in the last 2 years (130 cases). converted cases had a Median±SD age 53±17 years and 67% were female.

Conclusions Several risk factors favour conversion from laparoscopic to an open approach in biliary surgeries that has to be identified preoperative to provide a better surgery.