scholarly journals Cholecystectomy, Conversion and Complications

HPB Surgery ◽  
2000 ◽  
Vol 11 (6) ◽  
pp. 373-378 ◽  
Author(s):  
M. H. Thompson ◽  
J. R. Benger
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Complication Rate ◽  
Conversion Rate ◽  
Open Cholecystectomy ◽  
Consecutive Series ◽  
Intention To Treat ◽  
Open Operation ◽  
Complications Of Laparoscopic Cholecystectomy ◽  
Complication Score ◽  
Small Advantage

Background Faced with a difficult laparoscopic cholecystectomy the surgeon may feel that conversion to open operation would risk greater complications because of the laparotomy. Information on the effect of conversion is lacking. The purpose of this study is to measure the complications of laparoscopic cholecystectomy and observe the effect of the conversion rate.Methods A total of 957 patients were studied. There were three consecutive series of patients; the first undergoing open cholecystectomy (384 patients), the second laparoscopic cholecystectomy with a 5.8% conversion rate (412 patients) and the third laparoscopic cholecystectomy with a 1.3% conversion rate (161 patients). Data was collected prospectively using a continuous audit, and the complication rate compared on an intention to treat basis. In addition a panel of experienced surgeons was asked to score the complications depending on their severity and a composite complication score calculated. Comparison between the 3 groups was then undertaken. Results Open cholecystectomy produced a postoperative complication rate of 6%. Initially this appeared to fall to 3.1% with the introduction of laparoscopic cholecystectomy, but when the complications occurring in the converted patients were included (i.e., on an intention to treat basis) the rate increased to 5.6% in the first group of laparoscopically- treated patients and 3.1% in the second. These differences were not statistically significant. A similar pattern emerged when scoring the severity of the complications as judged by the expert panel. The inclusion of intra-operative complications appears to remove any small advantage for laparoscopic cholecystectomy. The reduction in the conversion rate between the two laparoscopic groups from 5.8% to 1.2% was statistically significant.Conclusion When considered on an intention to treat basis laparoscopic cholecystectomy offers no advantage over open operation in terms of the frequency or severity of complications. Reducing the frequency of conversion from a laparoscopic to an open procedure also has no significant effect on the complications encountered. We conclude, therefore, that the complication rate is independent of the conversion rate and that the surgeon, when faced with difficulty at laparoscopic cholecystectomy, should not be deterred from converting to open operation for fear of the post-operative consequences.

scholarly journals Laparoscopic Cholecystectomy - A Cross Sectional Study

2015 ◽  
Vol 2 (1) ◽  
pp. 53
Author(s):  
Pari A. Pulate ◽  
Tushar Narkhede ◽  
Sushma S. Chandak
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Complication Rate ◽  
Open Cholecystectomy ◽  
Cross Sectional Study ◽  
Chronic Cholecystitis ◽  
Histopathological Diagnosis ◽  
Early Recovery ◽  
Cross Sectional ◽  
Complications Of Laparoscopic Cholecystectomy ◽  
Bladder Polyp

<strong>Aims and Objectives:</strong> 1. To study the clinical profile of patients undergoing laparoscopic cholecystectomy. 2. To study the post operative complications of laparoscopic cholecystectomy. <strong>Methodology:</strong> Ultrasound confirmed 48 cases of either sex admitted in department of surgery with cholelithiasis, gall bladder polyp, acute or chronic cholecystitis were included in this survey. These patients underwent laparoscopic cholecystectomy after preoperative preparation during August 2011-December 2013. <strong>Results:</strong> Highest age incidence was seen in 4<sup>th</sup> decade with female preponderance. Most common presenting symptom was pain in abdomen followed by nausea, vomiting, dyspepsia and fever. Only 1 procedure was converted to open cholecystectomy with conversion rate of 2.08%. It was due to dense adhesions from chronic infection. The overall post-operative complication rate was 6.25% with wound infection being the most common occurring in 2 cases and prolonged ileus in 1 case. Chronic cholecystitis was the major histopathological diagnosis. The median post-operative stay in our study was 3 days. <strong>Conclusion:</strong> Chronic cholecystitis is the most common presentation of cholelithiasis with female pre-ponderance and incidence more in the 4<sup>th</sup> decade. Laparoscopic cholecystectomy is safe and feasible treatment with less complication rate and early recovery.

scholarly journals Laparoscopic Cholecystectomy: One Surgeon’s Experience in 100 Consecutive Cases

1994 ◽  
Vol 8 (4) ◽  
pp. 277-278
Author(s):  
Ivan J Pokorny
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Conversion Rate ◽  
Community Hospital ◽  
Open Cholecystectomy ◽  
Hospital Setting ◽  
Standard Technique ◽  
Major Complications ◽  
Gallbladder Removal

Initial 100 consecutive laparoscopic cholecystectomies performed by one surgeon were studied prospectively. The standard technique was modified in that the gallbladder removal was accomplished through the upper epigastric incision; there was no need to change the location of the camera. The conversion rate to open cholecystectomy was 2%. There were no major complications and no mortality. Minor complications occurred in 9% of the patients. Laparoscopic cholecystectomy can be performed safely in a community hospital setting. Simplified technique of gallbladder extraction is recommended.

scholarly journals Xanthogranulomatous cholecystitis: A clinicopathological study from a tertiary care health institution

1970 ◽  
Vol 6 (4) ◽  
pp. 472-475 ◽  
Author(s):  
PBS Kansakar ◽  
G Rodrigues ◽  
SA Khan
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Conversion Rate ◽  
Preoperative Diagnosis ◽  
Open Cholecystectomy ◽  
Bladder Wall ◽  
Tertiary Care ◽  
Chronic Cholecystitis ◽  
Clinical Aspects ◽  
Wall Thickening ◽  
Xanthogranulomatous Cholecystitis

Background: Xanthogranulomatous cholecystitis is an unusual and destructive form of chronic cholecystitis and is indistinguishable from other forms of cholecystitis which makes preoperative diagnosis and surgery difficult. Objectives: To review the demographic and clinical aspects of xanthogranulomatous cholecystitis; to study the possibility of preoperative diagnosis and to identify the causes for difficult surgery. Materials and methods: All cases histopathologically diagnosed as xanthogranulomatous cholecystitis over a period of six years from October 1999 to September 2005 at Kasturba Medical College Hospital, Manipal, India were included in the study. Data of the patients was collected retro and prospectively. Results: A total of 615 patients underwent cholecystectomy out of which 33 (5.2%) were diagnosed to have xanthogranulomatous cholecystitis. Ultrasound abdomen showed gallbladder wall thickening in 19 (57.5%) cases and gallstones in 32 (96.9%) cases. Thirty (90.9%) underwent open cholecystectomy. Gallbladder could be removed totally in 25 (75.6%) cases whereas five (15.2%) had to undergo partial cholecystectomy and in one patient, only cholecystostomy could be performed due to dense adhesions. Laparoscopic cholecystectomy was attempted in 11 patients but successful only in two patients with a conversion rate of 81.8%. Postoperative wound infection was seen in five (15.1%) patients and one (3%) had minor biliary leak which was treated conservatively. Histologically, xanthogranulomatous cholecystitis was associated with malignancy in one (3.03%) patient. There was no mortality. Conclusion: Clinical presentation of xanthogranulomatous cholecystitis was indistinguishable from chronic cholecystitis. Ultrasonography may reveal only non specific findings of calculi and thickened gall bladder wall. Hence preoperative diagnosis is unlikely. Cholecystectomy was usually difficult owing to dense adhesions of gallbladder and Calot's triangle. Conversion rate of laparoscopic cholecystectomy is higher. Morbidity associated with surgery is significant. Key words: Xanthogranulomatous cholecystitis, Cholecystectomy, Malignancy doi: 10.3126/kumj.v6i4.1738   Kathmandu University Medical Journal (2008), Vol. 6, No. 4, Issue 24, 472-475

scholarly journals Rate and Risk Factors for Conversion and Complications of Laparoscopic Cholecystectomy.

2018 ◽  
Vol 27 (2) ◽  
pp. 58-62
Author(s):  
MM Sarker ◽  
MK Sarker ◽  
NA Perveen
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Conversion Rate ◽  
Open Cholecystectomy ◽  
Preoperative Assessment ◽  
Biliary Leakage ◽  
College Hospital ◽  
Excessive Bleeding ◽  
Port Site Hernia ◽  
Conversion To Open Cholecystectomy ◽  
Operative Complications

Laparoscopic Cholecystectomy has become the gold standard for the surgical treatment of gall bladder disease, but conversion to open cholecystectomy and both operative and post operative complications are still inevitable in certain cases. Knowledge of the rate and impact of the underlying reasons for conversion and complications could help surgeons during preoperative assessment and improve the informed consent of patients. In this study we retrospectively evaluated the rate and reasons for conversion and assessed complications of our laparoscopic cholecystectomy series. We included data of 720 consecutive patients who were attempted to laparoscopic cholecystectomy between January 2008 to March 2014 at Islami Bank Medical College Hospital, Rajshahi. The study included 468 (65%) female and 252 (35%) male with mean age of 38 years (range 16-78 years). Conversion to open procedure was carried out in 58 patients with conversion rate of 8.05%. Dense and extensive adhesions were the most common reasons for conversion (21, 36. 2%). The conversion rate due to operative complications was 13.8% of all converted cases. The major operative complications were extrahepatic bile ducts injuries 2(0.3%), duodenal injury 1(0.1%), excessive bleeding 10(1.4%). The incidence of postoperative complications was 2.8%. The most common post-operative complication was wound infection (11, 1. 52%) followed by biliary leakage in 4(0.55%) patients. Delayed complications seen in our series is port site hernia (1,0.13%). Laparoscopic cholecystectomy is the preferred method even in difficult cases. Conversion from laparoscopic to open cholecystectomy should be based on the sound clinical judgment of the surgeon and not be due to a lack of individual expertiseTAJ 2014; 27(2): 58-62

scholarly journals Laparoscopic cholecystectomy: Conversion rate and complcation

2016 ◽  
Vol 18 (3) ◽  
pp. 43
Author(s):  
BR Malla ◽  
HN Joshi ◽  
N Rajbhandari ◽  
YR Shakya ◽  
B Karki ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Conversion Rate ◽  
Open Cholecystectomy ◽  
Gallbladder Disease ◽  
Conversion To Open Surgery ◽  
Calot’S Triangle ◽  
Conversion Rates ◽  
Conversion To Open Cholecystectomy ◽  
Previous Laparotomy ◽  
History Of

Introduction and Objective: Laparoscopic Cholecystectomy is the standard surgical treatment for gallbladder disease. However, conversion to open surgery is not the complication. Different centers have reported different conversion rates and post operative complications. The objective of this study is to identify conversion rate and post operative complication of laparoscopic cholecystectomyMaterials and Methods: This retrospective study included all laparoscopic cholecystectomies attempted in Dhulikhel hospital during the year 2015. Files of all patients were reviewed to find out the demography of the patients and the indication of Laparoscopic cholecystectomy. The rate of conversion to open cholecystectomy, the underlying reasons for conversion and postoperative complications were analyzed.Results: Out of 324 cases attempted laparoscopic cholecystetomies, two cases with the history of previous laparotomy were excluded to rule out the bias in the result. Out of 322 cases 226(70.18%)were female and 96(29.81%) were male . The mean age was 38 years. Over all conversion rate to open cholecystetomy was 1.86% with frozen calot’s triangle as the most common reason for conversion. The over all postoperative complication was 1.24% with no major bile duct injury.Conclusion: Laparoscopic cholecystectomy can safely be done with low conversion rate and complication.

scholarly journals Optimal timing of laparoscopic cholecystectomy after endoscopic retrograde cholangiopancreatography

2017 ◽  
Vol 4 (10) ◽  
pp. 3504 ◽  
Author(s):  
Rasmiranjan Sahoo ◽  
Debasish Samal ◽  
A. Pradhan ◽  
Rima Sultana ◽  
Nabakishore Nayak ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Conversion Rate ◽  
Open Cholecystectomy ◽  
Secondary Outcome ◽  
Optimal Timing ◽  
Endoscopic Retrograde ◽  
Early Laparoscopic Cholecystectomy ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

Background: Nowadays in patients with cholelithiasis with choledocholithiasis, the ideal treatment is endoscopic retrograde cholangiopancreatographic (ERCP) removal of duct stone and laparoscopic cholecystectomy. But when to do and whether we can do it simultaneously or one after another and what interval should be there, that is always controversial. The purpose was an optimal gap for cholecystectomy after ERCP.Methods: We have done a comparison study in 60 patients within a duration of 2 year who had already done ERCP. Group 1, those patients who had laparoscopic cholecystectomy within 72 hours compared with group 2 who had laparoscopic cholecystectomy after an interval of 6 week. Primary outcome was the conversion rate from lap to open cholecystectomy. Secondary outcome was duration of operation, intra-operative difficulties, postoperative morbidity and hospital stay.Results: Of 60 consecutive patients 30 were in group I and 30 were in group II. There is no difference in demographics, laboratory or ultrasonographic findings. The hospital stays in group I is significantly shorter than group II and conversion rate; operative time is higher in group II. No statistically significant difference in post-operative morbidity between both groups.Conclusions: Early laparoscopic cholecystectomy within 72 hr is better than interval (6 week) cholecystectomy after ERCP with shorter hospital stay and less intraoperative difficulties.

scholarly journals Clinical Impact of Preoperative Relief of Jaundice Following Endoscopic Retrograde Cholangiopancreatography on Determining Optimal Timing of Laparoscopic Cholecystectomy in Patients with Cholangitis

2021 ◽  
Vol 10 (19) ◽  
pp. 4297
Author(s):  
Kyu-Hyun Paik ◽  
Yoon Suk Lee ◽  
Won-Suk Park ◽  
Yong Chan Shin ◽  
Woo Hyun Paik
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Hospital Stay ◽  
Conversion Rate ◽  
Open Cholecystectomy ◽  
Optimal Timing ◽  
Endoscopic Retrograde ◽  
Perioperative Morbidity ◽  
Group 1

Background: About 10% of patients with gallbladder (GB) stones also have concurrent common bile duct (CBD) stones. Laparoscopic cholecystectomy (LC) after removal of CBD stones using endoscopic retrograde cholangiopancreatography (ERCP) is the most widely used method for treating coexisting gallbladder and common bile duct stones. We evaluated the optimal timing of LC after ERCP according to clinical factors, focusing on preoperative relief of jaundice. Methods: A total of 281 patients who underwent elective LC after ERCP because of choledocholithiasis and cholecystolithiasis from January 2010 to April 2018 were retrospectively reviewed. We compared the hospital stay, perioperative morbidity, and rate of surgical conversion to open cholecystectomy according to the relief of jaundice before surgery. These enrolled patients were divided into two groups: relief of jaundice before surgery (group 1, n = 125) or not (group 2, n = 156). Results: The initial total bilirubin level was higher in group 1; however, there were no significant differences in the other baseline characteristics including age, sex, American Society of Anesthesiologists score, previous surgical history, white blood cell count, C-reactive protein, and operative time between the two groups. There was also no significant difference in postoperative hospital stay between the two groups (4.5 ± 3.3 vs. 5.5 ± 5.6 days, p = 0.087). However, after ERCP, the waiting time until LC was significantly longer in group 1 (5.0 ± 4.9 vs. 3.5 ± 2.4 days, p < 0.001). There were no statistical differences in the conversion rate (3.2% vs. 3.8%, p = 0.518) or perioperative morbidity (4.0% vs. 5.8%, p = 0.348), either. Conclusions: LC would not be delayed until the relief of jaundice after ERCP since there were no significant differences in perioperative morbidity or surgical conversion rate to open cholecystectomy. Early LC after ERCP may be feasible and safe in patients with cholangitis and cholecystolithiasis.

scholarly journals Clinical Effect and Effective Rate of Laparoscopic Cholecystectomy for Gallstones Complicated with Gallbladder Polyps

2021 ◽  
Vol 271 ◽  
pp. 03046
Author(s):  
Xiaoming Deng ◽  
Jinjun Jiang
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Clinical Efficacy ◽  
Complication Rate ◽  
Open Cholecystectomy ◽  
Effective Rate ◽  
Control Group ◽  
Observation Group ◽  
Clinical Indicators ◽  
Gallbladder Polyps ◽  
Operation Duration

This paperA total of 62 patients with gallstones and gallbladder polyps were selected from May 2019 to May 2020, who were divided into the observation group (n=31, laparoscopic cholecystectomy) and the control group (n=31, open cholecystectomy) in a 1:1 ratio. The clinical indicators, clinical efficacy, level of pain and complication rate of the two groups were recorded and compared. Results Indicators such as the operation duration (38.64±14.42min), blood loss (30.42±8.21ml), length of stay (4.71±1.82 d), first anal exhaust (21.82±6.65min), drainage volume (72.02±4.21ml), length of incision and the time for the recovery of gastrointestinal functions in the observation group were better than the control group (P<0.05). The clinical efficacy of the observation group (96.77%) was higher than that of the control group (80.65%), with statistical value =4.0260 (P<0.05). The level of pain of the observation group was lower than that of control group (P<0.05), while the complication rate in the observation group (3.22%) was also lower than that of the control group (22.58%) (P<0.05). Laparoscopic cholecystectomy is an effective treatment of gallstones complicated with gallbladder polyps, which can alleviate pain and improve the prognosis, and is thus worthy of promotion.

scholarly journals Patterns of complications and outcome of laparoscopic cholecystectomy

2020 ◽  
Vol 7 (2) ◽  
pp. 484
Author(s):  
Prem Chand ◽  
Shivanshu Kundal ◽  
Savijot Singh ◽  
Sangam Papneja ◽  
Jaspal Singh
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Side Effects ◽  
Complication Rate ◽  
Open Cholecystectomy ◽  
Standard Procedure ◽  
Major Complication ◽  
Cost Effective ◽  
Conversion To Open Cholecystectomy ◽  
Bladder Pathology ◽  
Major Complication Rate

Background: Cholelithiasis is known to be one of the most common biliary pathologies. Laparoscopic cholecystectomy is the gold standard for the removal of the gallbladder, because of its cosmetic benefit, short stay, cost-effective and lesser side effects. But no procedure is immune to complications and other procedure-related side effects. The present study was conducted to study the patterns of complications and outcome of laparoscopic cholecystectomy.Methods: the present study was conducted prospectively on patients undergoing laparoscopic cholecystectomy for symptomatic gall bladder pathology. the patients undergoing laparoscopic cholecystectomy were distributed and analysed on various parameters i.e. age, sex, ultrasound abdomen findings, complications related to access, per-operative condition of gallbladder, per-operative and postoperative complication.Results: In our study cases major complication rate 1% leading to biliary stricture for which hepaticojejunostomy was done, minor complication rate 11% and conversion to open cholecystectomy rate 2%.Conclusions: It is concluded that laparoscopic cholecystectomy is the safe and standard procedure for the laparoscopic cholecystectomy and its major complication are preventable by strictly following the basic principles of laparoscopic cholecystectomy and keeping a low level of the threshold for converting to open cholecystectomy.

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