Conversion Rate of Laparoscopic Cholecystectomy to Open Surgery at Al Karamah Teaching Hospital, Iraq

Abstract

Background: Laparoscopic cholecystectomy has become the standard treatment for symptomatic gall bladder disease. However, there still a substantial proportion of patients in whom Laparoscopic cholecystectomy cannot be successfully performed, and for whom conversion to open surgery is required. Method: In this study, 1600 laparoscopic cholecystectomy performed at Al karamah teaching hospital from January 2010 to January 2015, were prospectively analyzed. The patients studied included 1600, 1245 where females (78.4%) and 346 where males (21.6%) with a mean age of 41.2 years. From the data collected, only factors available to surgeon preoperatively were considered for analysis. These factors included: age, gender, history of acute Cholecystitis, jaundice, previous abdominal surgery, obesity and concomitant disease, ultrasound preoperatively & ERCP. Results: Of the 1600 patients in whom Laparoscopic cholecystectomy was attempted 56 patients (3.5%) required conversion to open surgery. The most common reason for conversion was difficult to define anatomy in patients with inflamed, contracted gall bladder (n = 42). Significant predictor factors for conversion were male gender, previous abdominal surgery, acute Cholecystitis, and obesity. Conclusion: An appreciation for these predictors for conversion will allow appropriate planning by the patient, the institution and the surgeon.