A prospective observational study of predictive factors for conversion of laparoscopic to open cholecystectomy

Abstract

Background: Cholelithiasis affects about 10 to 15% of general population. LC became the procedure of choice for management of symptomatic gallstone disease for its minimally invasive nature, minimal pain and earlier recovery. Methods: This study was carried out on 300 consecutive patients who underwent LC for gall stone disease (patients falling under inclusion criteria) in the Department of General Surgery, The Calcutta Medical Research Institute, Kolkata. Results: In this study 9% patient were converted to open cholecystectomy while 91% of the patient underwent successfully LC. Increased wall thickness of gall bladder (p=0.01), pericholecystic fluid collection (p=0.04), stone impaction at gall bladder neck (p=0.001), pain abdomen (acute cholecystitis, recurrent acute cholecystitis) (p=0.03), previous abdominal surgery (p=0.001), pre-operative jaundice (p=0.005) were found significant in this study for conversion to open surgery. Increased TLC, total bilirubin, alkaline phosphatase, alanine transaminase and aspartate transaminase (p<0.05) were also risk factors for conversion to open surgery. Conclusions: We conclude that LC is the gold standard treatment for gall stone disease. Identification and safeguarding the bile ducts and arteries is of utmost importance while performing LC.