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 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 OUTCOME OF LAPAROSCOPIC CHOLECYSTECTOMY IN PATIENTS WITH GALLSTONE DISEASE AT A SECONDARY LEVEL CARE HOSPITAL

2018 ◽  
Vol 31 (1) ◽  
Author(s):  
Ahmed TAKI-ELDIN ◽  
Abd-Elnaser BADAWY
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Stay ◽  
Operative Time ◽  
Open Cholecystectomy ◽  
Gallstone Disease ◽  
Care Hospital ◽  
Biliary Leakage ◽  
Port Site Hernia ◽  
Conversion To Open Cholecystectomy ◽  
Secondary Hospital

ABSTRACT Background: Laparoscopic cholecystectomy is the most commonly performed operation of the digestive tract. )It is considered as the gold standard treatment for cholelithiasis. Aim: To evaluate the outcome of it regarding length of hospital stay, complications, morbidity and mortality at a secondary hospital. Methods: Data of 492 patients who underwent laparoscopic cholecystectomy were retrospectively reviewed. Patients’ demographics, co-morbid diseases, previous abdominal surgery, conversion to open cholecystectomy, operative time, intra and postoperative complications, and hospital stay were collected and analyzed from patients’ files. Results: Out of 492 patients, 386 (78.5%) were females and 106 (21.5%) males. The mean age of the patients was 49.35±8.68 years. Mean operative time was 65.94±11.52 min. Twenty-four cases (4.9%) were converted to open surgery, four due to obscure anatomy (0.8%), 11 due to difficult dissection in Calot’s triangle (2.2%) and nine by bleeding (1.8%). Twelve (2.4%) cases had biliary leakage, seven (1.4%) due to partial tear in common bile duct, the other five due to slipped cystic duct stables. Mean hospital stay was 2.6±1.5 days. Twenty-one (4.3%) developed wound infection. Port site hernia was detected in nine (1.8%) patients. There was no cases of bowel injury or spilled gallstones. There was no mortality recorded in this series. Conclusions: Laparoscopic cholecystectomy is a safe and effective line for management of gallstone disease that can be performed with acceptable morbidity at a secondary hospital.

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 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 Outpatient Laparoscopic Cholecystectomy

HPB Surgery ◽  
1994 ◽  
Vol 7 (4) ◽  
pp. 261-264 ◽  
Author(s):  
R. Smith ◽  
D. Kolyn ◽  
R. Pace
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Open Cholecystectomy ◽  
Nausea And Vomiting ◽  
Post Operative Period ◽  
Conversion To Open Cholecystectomy ◽  
Operative Complications ◽  
The Future ◽  
Elective Cholecystectomy ◽  
Post Operative Complications

Outpatient Laparoscopic Cholecystectomy was attempted in 98 patients selected from 266 patients presenting for elective cholecystectomy (37%). Two patients required admission following conversion to “open” Cholecystectomy, one patient was admitted for observation because of a technically difficult Laparoscopic Cholecystectomy and 16 patients were admitted because of refractory nausea and vomiting in the early post-operative period. Seventy-nine patients (81%) were able to be discharged home within 4 to 6 hours of surgery, with only one patient requiring readmission to hospital because of the onset of nausea and vomiting. There were no post-operative complications attributable to the outpatient experience. We believe this approach to elective gallbladder pathology can be safely accomplished in selected patients and will be increasingly utilized in the future.

scholarly journals Outcome of laparoscopic cholecystectomy in terms of intraoperative complications in a tertiary care hospital.

2021 ◽  
Vol 29 (01) ◽  
pp. 19-25
Author(s):  
Muhammad Sayyar ◽  
Yousaf Jan ◽  
Shaukat Hussain
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Intraoperative Complications ◽  
Open Cholecystectomy ◽  
Tertiary Care ◽  
Abdominal Ultrasound ◽  
International Studies ◽  
Care Hospital ◽  
Research Committee ◽  
Conversion To Open Cholecystectomy ◽  
Operative Complications

Objectives: The main objective was to evaluate the outcome of laparoscopic cholecystectomy in terms of intra-operative complications and the rate and reasons of conversion to open cholecystectomy. Study Design: Descriptive Study. Setting: Hayatabad Medical Complex, Peshawar. Period: June 2018 to May 2019. Material & Methods: After taking consent of Hospital ethical & research committee, patients admitted with clinical diagnosis of cholelithiasis and chronic cholecystitis, confirmed by abdominal ultrasound, undergoing laparoscopic cholecystectomy fulfilling inclusion criteria were selected. Results: A total of 150 were included in the study. Mean age was 39.2yrs with female to male ratio of 9.75:1. Laparoscopic cholecystectomy was successfully accomplished in 98% cases. In 2% (3 patients) converted cases the most common cause of conversion observed was dense adhesions in the calots triangle. Intra-operative complications were noted in 1.4% patients, those included bile duct injury and leakage from the gallbladder bed. However other complications such as bowel injury, blood vessel injury, and post operative hemorrhage did not occur. Overall morbidity was 1.4% with no mortality. Conclusion: Laparoscopic cholecystectomy is a safe and effective procedure in our setup to the accepted standards, as evident by the national and international studies. And it can be accomplished with minimal morbidity and low rate of conversion with the increasing surgeon’s experience.

scholarly journals Safety and feasibility of three port procedure in laparoscopic cholecystectomy

2019 ◽  
Vol 6 (6) ◽  
pp. 1975
Author(s):  
Vipin Gupta ◽  
Shailendra Pal Singh ◽  
Somendra Pal Singh ◽  
Anil Kumar Keshari ◽  
Anil Kumar Erry ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Operative Time ◽  
Open Cholecystectomy ◽  
Standard Technique ◽  
Post Operative Pain ◽  
Conversion To Open Cholecystectomy ◽  
Operative Complications ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Laparoscopic cholecystectomy is widely accepted gold standard technique for management of cholelithiasis and has undergone many refinements including decrease in size and number of ports. Many researchers have claimed that three-port laparoscopic cholecystectomy is safe and feasible method for management of cholelithiasis but still it is not performed widely by the surgeons. Objective of our study was to assess the safety and feasibility of three-port laparoscopic cholecystectomy by comparing the various defined parameters with the standard four-port laparoscopic cholecystectomy.Methods: The study included 100 patients and was divided equally in 2 groups. Patients in Group A underwent laparoscopic cholecystectomy by three-port technique and in Group B were operated by four-port technique. Patients in both the groups were compared in terms of operative time, intra-operative complications, post-operative pain, post-operative complications and cosmesis outcome.Results: The mean operative time was similar in both groups. Intra-op and post-op complications were also similar. 3 patients in Group A needed fourth port and 1 patient in both group required conversion to open cholecystectomy. Mean pain score and requirement of parentral analgesia was found to be lower in Group A. Duration of hospital was similar in both the groups. Patients in group A had slightly better cosmetic outcome.Conclusions: Three-port laparoscopic cholecystectomy is a minimally invasive, safe and feasible technique and is not difficult to master than other advanced techniques. In experienced hands, laparoscopy cholecystectomy can be initially started with three-ports and can be converted to four-port if rarely necessary.

LAPAROSCOPIC CHOLECYSTECTOMY IN ACUTE CHOLECYSTITIS: A PROSPECTIVE STUDY.

2019 ◽  
Author(s):  
Madan Goyal ◽  
R K Goel
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Open Cholecystectomy ◽  
Critical View Of Safety ◽  
Recent Onset ◽  
Conversion To Open Cholecystectomy ◽  
Threatening Condition ◽  
Life Threatening ◽  
Fluid Collections ◽  
A Prospective Study

Acute cholecystitis (AC) is a potentially life-threatening condition. LC was initially considered to be a relative contraindication for laparoscopic cholecystectomy (LC), but with increase in general expertise, early LC was recommended in selected patients1. Aprospective study of LC in grade 1 and 2 AC patients with mild to moderate inflammatory changes in the gallbladder and no significant organ dysfunction, was performed during October 2016 to July 2019. A total of 78 patients, out of 408 cholecystectomies performed during this period, were included in this study. Criteria for diagnosing AC was, recent onset of pain in right hypochondrium, fever, leucocytosis, pericholecystic fluid collections, subserosal oedema on ultrasound, pyocele and other pathological evidence of AC. Patients presented and operated within 4 days of onset of symptoms showed better results as compared to those who could be operated after 4 days and within 14 days. Five patients required conversion to open cholecystectomy because of complex adhesions in 2, critical view of safety was unachievable in 2 and in 1 for troublesome bleeding.

EVALUATION OF CLINICO-RADIOLOGICAL FACTORS PREDICTING DIFFICULT LAPAROSCOPIC CHOLECYSTECTOMY

2021 ◽  
pp. 63-66
Author(s):  
Wasif Mohammad Ali ◽  
Nazia Nanen ◽  
Atia Zaka Ur Rab ◽  
Syed Amjad Ali Rizvi ◽  
Mehtab Ahmad
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Open Cholecystectomy ◽  
Previous History ◽  
Safe Procedure ◽  
Chi Square ◽  
Preoperative Prediction ◽  
Conversion To Open Cholecystectomy ◽  
Chi Square Test ◽  
A Prospective Study

Introduction: Laparoscopic cholecystectomy has become procedure of choice for treatment of symptomatic gallstone [1] disease . Even though it is a safe procedure occasionally it can be difcult and requires conversion to open cholecystectomy for various problems faced during surgery. Preoperative prediction of difcult laparoscopic cholecystectomy and likelihood of conversion to open cholecystectomy will avoid such complications and overall cost of treatment. Aim: To evaluate the clinico-radiological factors predicting difcult laparoscopic cholecystectomy Methods: This was a prospective study conducted from October 2018 to November 2020. Total of 101 patients meeting inclusion criteria undergoing laparoscopic cholecystectomy were included in the study. Various clinical, radiological and biochemical parameters and intraoperative difculties during surgery were recorded. The statistical analysis was done using chi-square test and ANOVA test. Results: The parameters such as sex, age, duration of disease, co-morbid disease, previous history of cholecystitis, palpable gall bladder, BMI, TLC, thickness of gall bladder, largest stone size and impacted stone are found statistically signicant in predicting difcult laparoscopic cholecystectomy and conversion to open cholecystectomy preoperatively. Conclusion: Difcult laparoscopic cholecystectomy may be predicted preoperatively even with a good clinical judgement whereas both clinical and radiological parameters provide a better preoperative prediction of difcult cholecystectomy so that the surgeon can prepared in advance for the complications.

scholarly journals Evaluation of predictive factors for conversion of laparoscopic cholecystectomy

1970 ◽  
Vol 7 (1) ◽  
pp. 26-30 ◽  
Author(s):  
R Gabriel ◽  
S Kumar ◽  
A Shrestha
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Predictive Factors ◽  
Open Cholecystectomy ◽  
Abdominal Cavity ◽  
Bladder Wall ◽  
Patient Factors ◽  
College Hospital ◽  
Biliary Pain ◽  
Conversion Rates

Background: Laparoscopic cholecystectomy has now replaced open cholecystectomy for the treatment of gallbladder diseases. However, certain cases still require conversion to open procedures. This study identifies and evaluates risk factors that may predict conversion from laparoscopic to an open procedure. Objectives: To identify and evaluate the predictive factors for conversion of laparoscopic to open cholecystectomy. Materials and methods: A total of 234 Laparoscopic cholecystectomies were attempted at the Kasturba Medical College Hospital, Manipal, from January 2003 to July 2005. Of these, 61 had to be converted to open cholecystectomy. A retro and prospective analysis of different parameters, including Patient factors, Intra-operative factors and Surgeon factors were performed. Results: Sixty one (26.1%) laparoscopic cholecystectomies required conversion. Factors contributing to conversion included male sex, age group of 31-40 years, over weight and history of biliary pain within last two to four months, ultrasonography findings of multiple calculi and gall bladder wall thickness of more than 3 mm. Intraoperative gall bladder perforation with spillage of its contents in abdominal cavity and dense adhesions with difficult anatomy resulted in higher conversion rates. Surgery performed by surgeons in learning phase of laparoscopic surgery was more prone to conversion. Conclusion: Patient factors, presentation, preoperative ultrasonography findings and surgeon's experience, all contribute to the possibility of conversion of laparoscopic cholecystectomy. Knowledge of these factors may help in preinformation to patient for psychological preparations for conversion and an experienced surgeon can plan to operate on these patients. Key words: Cholecystectomy, laparoscopy, conversion. doi: 10.3126/kumj.v7i1.1761       Kathmandu University Medical Journal (2009), Vol. 7, No. 1, Issue 25, 26-30     

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