scholarly journals Conversion from Laparoscopic to Open Cholecystectomy

2015 ◽  
Vol 1 (1) ◽  
pp. 30-32 ◽  
Author(s):  
Samir Shrestha ◽  
Surendra S Shah ◽  
Sanjay Poudyal ◽  
Jay N Shah ◽  
Vijay Kumar Jaiswal
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Abdominal Surgery ◽  
Open Surgery ◽  
Open Cholecystectomy ◽  
Health Sciences ◽  
Conversion To Open Surgery ◽  
Open Conversion ◽  
Previous Abdominal Surgery ◽  
Calot’S Triangle ◽  
Duration Of Surgery

Introductions: With the advent of newer technology, the era of open surgery for gall bladder diseases has been preferably taken over by laparoscopic cholecystectomy. However, certain cases still require conversion to open surgery. In this review we aim to analyze the reason for conversion. Methods: This retrospective study was conducted at Patan Hospital, Patan Acdemy of Health Sciences, Nepal. All patients who underwent laparoscopic cholecystectomy from February 2009 to July 2012 were included in the study. File numbers of all the patients were obtained from operation room register. The patient files were analyzed for age, sex, duration of symptoms, liver function tests, ultrasound findings and the description in operation note for reason for conversion. Results: The age ranged from 12 to 81 years with mean age of patients 32.76 years and male to female ratio 1:2.9. The mean operating time was 65 minutes and average post operative hospital stay was 1.61 days. Out of 305 patients, 34 (11.14%) required open conversion. Factors responsible for open conversion were dense fibrosis at Calots in 11 (3.6%), adhesions due to previous abdominal surgery in 6 (1.9%), uncontrollable bleeding in 5 (1.6%), bile duct injury in 4 (1.3%) cholecystoenteric fistula in 3 (0.9%), Mirizzi’s syndrome 2(0.6%). Conclusions: Adhesions at the calot’s triangle was the common reason for conversion from laparoscopic to open cholecystectomy. Plain Language Summary: This study was conducted to determine the predictive factors for conversion of laparoscopic cholecystectomy. The study found that dense adhesion around calot’s triangle and adhesions pertaining to previous abdominal surgery were the main reasons for conversion to open surgery. So, before embarking on laparoscopic cholecystectomy, it is essential to take detail history and examination, to rule out the probable cause of conversion beforehand and minimize; morbidity, duration of surgery and cost. DOI: http://dx.doi.org/10.3126/jpahs.v1i1.13013 Journal of Patan Academy of Health Sciences. 2014 Jun;1(1):30-32 

scholarly journals Conversion of laparoscopic cholecystectomy to open cholecystectomy in a single center

2021 ◽  
Vol 9 (2) ◽  
pp. 14-18
Author(s):  
Suttam Kumar Biswas ◽  
Shilpi Rani Roy ◽  
Subbrata Sarker ◽  
Md Mustafizur Rahman ◽  
Kamrul Islam
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Open Surgery ◽  
Open Cholecystectomy ◽  
Gallbladder Disease ◽  
Preoperative Assessment ◽  
College Hospital ◽  
Conversion To Open Surgery ◽  
Calot’S Triangle ◽  
Number Of Patients ◽  
Conversion To Open Cholecystectomy

Laparoscopic cholecystectomy (LC) has become the gold standard for the surgical treatment of gallbladder disease, but conversions to open cholecystectomy are still inevitable in certain cases. Knowledge about the rate and underlying reasons for conversion could help surgeons during preoperative assessment and improve the informed consent of patients. We decide to review the rate and causes of conversion of our LC series. This study included 320 consecutive laparoscopic cholecystectomies from January 2017 to December 2019 at Community Based Medical College Hospital Bangladesh, Mymensingh. All patients had surgery performed by same surgeon. Conversion to open cholecystectomy required in 15 (4.6%) patients. Out of 15 cases, the highest number of patients 10(66.6%) were in age group 50 to 59 years with a mean age of 60.1 years and standard deviation (SD) of 9.8 years. Of them 9 (60%) were male. The most common reasons for conversion of them were severe adhesions at calot's triangle 6 (40%) and acutely inflamed gallbladder 5 (33.3%), bleeding 2 (13%). No surgical procedures are complication free. The most common complication was superficial wound infection 8(2.5%). Delayed complications seen in our series is port site incisional hernia 2 (0.62%). Male gender, age older than 60 years, previous upper abdominal surgery, diabetes, and severity of inflammation were all significantly correlated with an increased conversion rate to laparotomy. LC is the preferred method even in difficult cases. This study emphasizes that although the rate of conversion to open surgery and complication rate are low in experienced hands, the surgeons should keep a low threshold for conversion to open surgery. CBMJ 2020 July: Vol. 09 No. 02 P: 14-18

scholarly journals Rate of Conversion and Postoperative Complications of Laparoscopic Cholecystectomy in District Level Hospital of Bangladesh

1970 ◽  
Vol 6 (2) ◽  
pp. 74-77
Author(s):  
SK Biswas ◽  
JC Saha ◽  
ASMT Rahman ◽  
ASMZ Rahman ◽  
MM Rahman
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Complications ◽  
Open Surgery ◽  
Open Cholecystectomy ◽  
Gallbladder Disease ◽  
Key Words Laparoscopic Cholecystectomy ◽  
Biliary Leakage ◽  
Conversion To Open Surgery ◽  
Calot’S Triangle ◽  
Conversion To Open Cholecystectomy

Laparoscopic cholecystectomy (LC) has become the gold standard for the surgical treatment of gallbladder disease, but conversion to open cholecystectomy and postoperative complications are still inevitable in certain cases. Knowledge of the rate and underlying reasons for conversion and postoperative complications could help surgeons during preoperative assessment and improve the informed consent of patients. We decide to review the rate and causes of conversion and postoperative complications of our LC series. This study included 760 consecutive laparoscopic cholecystectomies from July 2006 to June 2011 at Faridpur Central Hospital and Faridpur Medical College Hospital. All patients had surgery performed by same surgeon. Conversion to open cholecystectomy required in 19 (2.5%) patients. The most common reasons for conversion were severe adhesions at calot's triangle (6, 0.83%) and acutely inflamed gallbladder (5, 0.66%). The incidence of postoperative complications was 1.58%. The most common complication was wound infection, which was seen in 5 (0.66%) patients followed by biliary leakage in 3 (0.40%) patients. Delayed complications seen in our series is port site incisional hernia (2, 0.26%). LC is the preferred method even in difficult cases. Our study emphasizes that although the rate of conversion to open surgery and complication rate are low in experienced hands, the surgeons should keep a low threshold for conversion to open surgery and it should not be taken as a step in the interest of the patient rather than be looked upon as an insult to the surgeon. Key words: Laparoscopic cholecystectomy (LC); Open cholecystectomy; Conversion; Complications; Calot's triangle DOI: http://dx.doi.org/10.3329/fmcj.v6i2.9204 FMCJ 2011; 6(2): 74-77

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 Our experience with retrograde technique in difficult laparoscopic cholecystectomy

2020 ◽  
Vol 7 (11) ◽  
pp. 3691
Author(s):  
Vamsi K. Malligurki
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Open Surgery ◽  
Open Cholecystectomy ◽  
Surgical Practice ◽  
Conversion To Open Surgery ◽  
Surgical Units ◽  
Surgical Expertise ◽  
Dissection Technique ◽  
Retrograde Technique ◽  
Difficult Cases

Background: Gall bladder pathologies are some of the commonly encountered conditions in one’s surgical practice. Cholecystectomy is among the routinely performed procedures in most surgical units. Laparoscopic surgery is preferred to open cholecystectomy because of its various advantages. In straightforward cases, the antegrade technique is routinely employed. The retrograde technique is generally reserved for the difficult cases. The retrograde technique may be used safely with adequate experience, thus reducing the need for conversion into open surgery.Methods: Total 100 cases of consecutive difficult laparoscopic cholecystectomies were included in this study, which were operated using retrograde technique.Results: Out of the 100 patients 79 were females and 21 were males. Mean age of the patients was 44.2 years. Out of the 100 cases, 98 cases could be successfully managed using the retrograde technique. 2 cases were converted to open surgery. Bleeding was encountered in 3 cases, which was successfully managed laparoscopically. Bile duct injury was seen in 1 case which was managed after conversion.Conclusions: With adequate surgical expertise and proper instrumentation, retrograde dissection technique may be safely used in difficult laparoscopic cholecystectomy, reducing the rate of conversion to open surgery.

scholarly journals Evaluation of difficulties in laparoscopic cholecystectomy

2017 ◽  
Vol 70 (9-10) ◽  
pp. 271-276
Author(s):  
Katarina Sarcev ◽  
Dimitrije Damjanov ◽  
Dijana Kosijer ◽  
Dragomir Damjanov
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Minimally Invasive ◽  
Open Surgery ◽  
Open Cholecystectomy ◽  
Invasive Procedure ◽  
Minimally Invasive Procedure ◽  
Conversion To Open Surgery ◽  
Preoperative Prediction ◽  
Conversion To Open Cholecystectomy ◽  
Group B

Introduction. For decades, laparoscopic cholecystectomy has been the gold standard in surgical treatment of patients with cholelithiasis all over the world. The main advantage of this approach is that it is a minimally invasive procedure for patients. Although this method is a routine in our country, there are certain cases where the presumed outcome of minimally invasive procedure is not achieved, and the surgery is converted to open surgery, or a subsequent laparoscopic surgery is performed, in order to deal with the complications. The aim of this study was to establish if it was possible to create a model for preoperative prediction of difficult laparoscopic cholecystectomies. Material and Methods. Two groups of patients were analyzed. Group A included patients with cholelithiasis who were studied in order to determine parameters associated with difficult laparoscopic cholecystectomies. Out of 16 analyzed parameters, 8 showed significant correlation with difficult laparoscopic cholecystectomies. Based on these parameters, a prediction model was established, consisting of five groups: I - easy (score 1), II - laparoscopic cholecystectomy with mild difficulties (score 2), III - laparoscopic cholecystectomy with major difficulties (score 3), IV - difficult (score 4), V - conversion to open surgery is expected (score 5). This model was preoperatively applied in patients with cholelithiasis included in group B. Results. The overall predictability of the model was 82%. The greatest prediction accuracy was achieved in groups II and III (98.3% and 100%, respectively). Conversion to open cholecystectomy was predicted in 76% of patients. Conclusion. Based on certain preoperative parameters it is possible to establish a model to predict a difficult laparoscopic cholecystectomy.

scholarly journals Determinants of conversion during laparoscopic cholecystectomy among a sample of Iraqi patients

2018 ◽  
Vol 5 (7) ◽  
pp. 2455
Author(s):  
Abutalib B. Alluaibi ◽  
Bahaa K. Hassan ◽  
Alaa H. Ali ◽  
Ahmed A. Muhsen
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Gall Bladder ◽  
Acute Cholecystitis ◽  
Open Cholecystectomy ◽  
Male Gender ◽  
Visceral Injury ◽  
Previous Abdominal Surgery ◽  
Calot’S Triangle ◽  
Conversion To Open Cholecystectomy

Background: Laparoscopic cholecystectomy has become a standard technique for gall bladder surgery of symptomatic cholelithiasis. However, conversion to open cholecystectomy is sometimes necessary. The aim of the present study was to assess the predictive factors that increase the possibility of conversion of laparoscopic cholecystectomy to open cholecystectomy.Methods: A total of 621 laparoscopic cholecystectomies were attempted at AL-Mawanee General Hospital and AL-Sader Teaching Hospital in Basrah, IRAQ from June 2012 till June 2016.Of these,43 had to be converted to open cholecystectomies. Patients assessed according to different factors, including age, sex, acute cholecystitis, adhesions of gallbladder and calot's triangle, obesity, previous abdominal surgery, anatomical variation of gallbladder and Calot's triangle and intraoperative complications (bleeding, bile duct injury, visceral injury).Results: Conversion to open cholecystectomy was performed in 43 patients (6.92%). The significant factors for conversions were adhesions of gallbladder and Calot's triangle(39.53%) followed by acute cholecystitis(34.88%). Rate of conversion in other factors are as the following i.e., isolated male gender (0%), age (0%), previous abdominal surgery (9.3%), obesity (2.33%), anatomical variations of gall bladder and calot's triangle (2.33%), intra operative complications including bleeding (4.65%), bile duct injury (4.65%), visceral injury (2.33%) were insignificant factors for conversion.Conclusions: Adhesions of gallbladder and calot's triangle is the most common predictive factor and cause for conversion from laparoscopic cholecystectomy to open cholecystectomy. Acute cholecystitis found to be the strongest factor for conversion despite its incidence is lower than adhesions of gall bladder and calots triangle. Male gender and age more than fifty years are not direct predictive factors for conversions.

scholarly journals THE CONVERSION TO OPEN SURGERY IN LAPAROSCOPIC CHOLECYSTECTOMY

2018 ◽  
Vol 1 (2) ◽  
pp. 57-61
Author(s):  
I. Slavu ◽  
V. Braga ◽  
L. Alecu
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Retrospective Study ◽  
Gold Standard ◽  
Preoperative Diagnosis ◽  
Open Surgery ◽  
Open Cholecystectomy ◽  
Safe Method ◽  
Conversion To Open Surgery ◽  
Conversion To Open Cholecystectomy

After more than 20 years from the beginning of laparoscopic surgery, laparoscopic cholecystectomy still holds a conversion rate of 5.1 % in the specialty literature. We have conducted a retrospective study based on the experience of the clinical unit of General Surgery within “Prof. Dr. A. Ionescu” Emergency Clinical Hospital, between 1997 and 2013. A number of 2,309 laparoscopic cholecystectomies were performed. The average age of the group was 47.3 years. Conversion was performed to a number of 58 patients (2.51%), out of which 74.13% women (no. = 43) and 26% men (no. 15). The average age of the patients to whom the conversion was performed was 57. Conversion to open cholecystectomy was more frequent in patients over 60 (no. 38). The main preoperative diagnosis in converted patients was acute lithiasic cholecystitis. Laparoscopic cholecystectomy is a safe method with optimal results, being considered the “gold standard” in the treatment of bladder lithiasis. Conversion to open surgery is an expression of the surgeon’s experience and wisdom.

scholarly journals THE STUDY OF CONVERSION OF LAPAROSCOPIC CHOLECYSTECTOMY TO OPEN CHOLECYSTECTOMY IN THE TREATMENT OF ACUTE CHOLECYSTITIS.

2019 ◽  
pp. 1-3
Author(s):  
Dug Tariq Hassan ◽  
Rayees Ahmad Bhat ◽  
Liyaqat Nazir ◽  
Shabir Ahmad Dar ◽  
Mohammad Zakiuddin
Keyword(s):  
Risk Factors ◽  
Laparoscopic Cholecystectomy ◽  
Laparoscopic Surgery ◽  
Open Surgery ◽  
Open Cholecystectomy ◽  
Medical Sciences ◽  
Preoperative Risk ◽  
Conversion To Open Surgery ◽  
Preoperative Risk Factors ◽  
Risk Scoring

BACKGROUND: Laparoscopic cholecystectomy has become the gold standard in the treatment of symptomatic cholelithiasis. Some patients require conversion to open surgery and several preoperative variables have been identified as risk factors that are helpful in predicting the probability of conversion.However,there is a need to devise a risk-scoring system based on the identified risk factors to (a) predict the risk of conversion preoperatively for selected patients, (b) prepare the patient psychologically, (c) arrange operating schedules accordingly, and (d) minimize the procedure-related cost and help overcome financial constraints,which is a significant problem in developing countries. AIM: This study was aimed to evaluate preoperative risk factors for conversion from laparoscopic to open cholecystectomy in our setting. MATERIALS AND METHODS:A case control study of patients who underwent laparoscopic surgery from May 2016 to April 2017 at Shere Kashmir Institute of Medical Sciences, Srinagar. All those patients who were converted to open surgery (n = 73) were enrolled as cases.Two controls who had successful laparoscopic surgery (n = 146) were matched with each case for operating surgeon and closest date of surgery. RESULTS:The final multivariate model identified two risk factors for conversion:ultrasonography signs of inflammation (adjusted odds ratio [aOR] = 8.5;95% confidence interval [CI]:3.3,21.9) and age > 60 years (aOR = 8.1;95% CI:2.9,22.2) after adjusting for physical signs,alkaline phosphatase and BMI levels. CONCLUSION: Preoperative risk factors evaluated by the present study confirm the likelihood of conversion. Recognition of these factors is important for understanding the characteristics of patients at a higher risk of conversion

Effect of previous abdominal surgery on short-term outcomes following laparoscopic colorectal surgery.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 653-653
Author(s):  
Masanori Hotchi ◽  
Yuhei Waki ◽  
Kazunori Tokuda ◽  
Masayoshi Obatake ◽  
Hiroshi Kotegawa ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Abdominal Surgery ◽  
Sigmoid Colon ◽  
Open Surgery ◽  
Laparoscopic Colorectal Surgery ◽  
Operating Time ◽  
Short Term ◽  
Conversion To Open Surgery ◽  
Previous Abdominal Surgery ◽  
The Impact

653 Background: The impact of previous abdominal surgeries on the need for conversion to open surgery and on short-term outcomes during/after laparoscopic colorectal surgery was retrospectively investigated. This retrospective cohort study was conducted from May 2004 through October 2012. This study was conducted at Tokushima University Hospital and Ehime Prefectural Central Hospital. Methods: A total of 145 consecutive patients who had undergone laparoscopic resection of the sigmoid colon and upper rectum were classified as not having previous abdominal surgery (NPAS group, n = 123) or as having previous abdominal surgery (PAS group, n = 22). Short-term outcomes were assessed between the two groups. Results: The population of previous abdominal surgery consisted of 6 appendectomy, 3 gastrectomy for gastric ulcer, 2 nephrectomy, 2 peritonitis and 11 others (2 duplication). There were no significant differences in age, gender, BMI, tumor location, tumor size, Stage, operating time, blood loss and number of lymph node harvest between the two groups. The conversion to open surgery was performed in 1 patient (4.5%) in the PAS group and 6 patients (4.9%) in the NPAS group. The intraoperative inadvertent enterotomy occurred in 1 patient in the NPAS group. There was no difference in postoperative morbility between the two groups. In the NPAS group, anastomotic leakage was observed in 3 cases. Ileus was observed in one case in the NPAS and none in the PAS. Postoperative hospital stay was 14 days in the PAS group and 16 days in the NPAS group. Conclusions: Short-term outcomes following laparoscopic surgery for sigmoid colon and upper rectal cancer with previous abdominal surgery are acceptable.

FACTORS ASSOCIATED WITH CONVERSION OF LAPAROSCOPIC CHOLECYSTECTOMY TO OPEN CHOLECYSTECTOMY; OUR EXPERIENCE

2021 ◽  
pp. 15-18
Author(s):  
Heet Amlani ◽  
Sakshi Singhal ◽  
Neelkamal Gupta ◽  
Jitendra K. Mangtani
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Abdominal Surgery ◽  
Wall Thickness ◽  
Conversion Rate ◽  
Intraoperative Complications ◽  
Open Cholecystectomy ◽  
Surgical Anatomy ◽  
Previous Abdominal Surgery ◽  
History Of ◽  
Wbc Count

BACKGROUND:LC has become the gold standard for treating symptomatic cholelithiasis. It is important to keep in mind that the primary goal of LC is the safe removal of the GB, Therefore conversion to open should not be deemed a failure. Conversion to laparotomy may denitively be identied with surgical anatomy in difcult dissection or to address intraoperative complications such as bleeding, biliary or bowel injury. Ideally conversion should be carried out before complication arises Method and material: The present study was done on 100 patients undergoing laparoscopic cholecystectomy in the Department of General Surgery at Mahatma Gandhi Hospital. Factors(brief history, preoperative investigation and ultrasound ndings) that could help predict convertion of lap. Cholecystectomy to open were idened and were analysised with IBM.SPSS statistics software Result: Observation and analysis of all the parameters studied. Total 6 patients out of 100 cases were converted to open cholecystectomy i.e. conversion rate is 6%. Association of conversion with age was signicant. Association of BMI with conversion rate was signicant. no signicant association of acute cholecystitis with conversion rate. no signicant association of history of jaundice with conversion rate. Association of previous abdominal surgery with conversion rate was signicant. Association of wbc count with conversion rate was not signicant. There was signicant association between GB wall thickness and conversion rate. No signicant association of impacted stone with conversion rate. No signicant association of pericholecystic uid with conversion rate. Colclusion:In our study signicant correlation was found between the following parameters and conversion BMI, Previous abdominal surgery and GB wall thickness rest factors were not signicant.

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