Analysis of Incidence and Risk Factors for Conversion from Laparoscopic to Open Cholecystectomy

Abstract

Background: Laparoscopic Cholecystectomy is regarded as the best treatment of gallstone diseases. Surgical procedures will at times require a switch in laparoscopic to open cholecystectomy, which will raise the morbidity, hospitalization, and expenditure.

Aim: To establish the incidence and risk factors of laparoscopy to open conversion of the gall bladder surgery.

Methodology: A one-year observational retrospective study was done in the Department of General Surgery, Great Eastern Medical School & Hospital,Andhra Pradesh, India and involved 120 patients who underwent Laparoscopic Cholecystectomy. Descriptive statistics and logistic regression were used to analyze demographic data, clinical features, lab investigations, imaging, intraoperative data, and conversion rate.

Results: Among 120 cases, 18 (15%) cases had to undergo conversion to open surgery. Acuity cholecystitis (33.3%), dense adhesions (27.8%), obesity (22.2%), and prior abdominal surgery (16.7%), were common causes. The relation between leukocytosis and gender (male), age (greater than 50 years) and age was statistically significant (p<0.05).

Conclusion: Laparoscopic to open cholecystectomy surgery conversion depends on numerous factors depending on the patient and the disease. Early identification of high-risk patients can potentially allow preoperative planning and prevention of complications.

Keywords: Laparoscopic cholecystectomy, Open cholecystectomy, Conversion rate, Gallstones, Risk factors, Acute cholecystitis