scholarly journals Assesment of Risk Factors For Conversion To Open Surgery In Patients Undergoing Laparoscopic Cholecystectomy

2016 ◽  
Vol 15 (10) ◽  
pp. 14-18
Author(s):  
Chaudhary Sanchit ◽  
Sharma Maneesh ◽  
Wig JD ◽  
Gupta NM ◽  
Mahajan Amit
Keyword(s):  
Risk Factors ◽  
Laparoscopic Cholecystectomy ◽  
Open Surgery ◽  
Conversion To Open Surgery

Risk Factors for Conversion to Open Surgery in Patients Undergoing Laparoscopic Cholecystectomy

2006 ◽  
Vol 30 (9) ◽  
pp. 1698-1704 ◽  
Author(s):  
Salleh Ibrahim ◽  
Tay Khoon Hean ◽  
Lim Swee Ho ◽  
T. Ravintharan ◽  
Tan Ngian Chye ◽  
...  
Keyword(s):  
Risk Factors ◽  
Laparoscopic Cholecystectomy ◽  
Open Surgery ◽  
Conversion To Open Surgery

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

scholarly journals Laparoscopic cholecystectomy in patients with liver cirrhosis: review of intraoperative measures and recommendations

2021 ◽  
Author(s):  
Tamer M. Abdelrahman
Keyword(s):  
Liver Cirrhosis ◽  
Laparoscopic Cholecystectomy ◽  
Open Surgery ◽  
Mortality Rates ◽  
Morbidity And Mortality ◽  
Intraabdominal Pressure ◽  
Biliary Stones ◽  
Conversion To Open Surgery ◽  
Trocar Placement ◽  
Surgical Teams

AbstractSymptomatic biliary stones are related with higher morbidity and mortality rates in patients with liver cirrhosis, especially when patients undergo surgery. The difficulty of cholecystectomy is worsened by liver cirrhosis, especially in patients with extensive liver fibrosis and portal hypertension.Laparoscopic cholecystectomy can be performed safely in selected patients with cirrhosis. However, it can be challenging in many aspects and poses a greater degree of difficulty and thus should be performed by experienced surgical teams, who follow the recommendations and take in mined the special precautions which requested to increase safety of the operation and avoid  or reduce the morbidity and mortality , and also who able to tackle the more frequent intraoperative incidents or complications.In this review, we focus on of the technical difficulties and intraoperative recommendations that could be used to approach laparoscopic cholecystectomy in this patient population (trocar placement, intraabdominal pressure, visualization, gallbladder dissection, adjunct for hemostasis, intraperitoneal drains, and conversion to open surgery), and the alternative which can be used in advanced cases  

scholarly journals Role of gallbladder wall thickness in predicting laparoscopic operability prior to cholecystectomy: a retrospective analysis

2018 ◽  
Vol 5 (5) ◽  
pp. 1885
Author(s):  
Priyank Pathak ◽  
Rihan Zaidi
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Wall Thickness ◽  
Open Surgery ◽  
Bladder Wall ◽  
Gallbladder Wall ◽  
Bladder Wall Thickness ◽  
Conversion To Open Surgery ◽  
Gall Bladder Wall ◽  
Calculous Cholecystitis

Background: Laparoscopic cholecystectomy is the gold standard procedure for cholecystitis. There are variable rates of conversion of laparoscopic cholecystectomy to open cholecystectomy. Various studies have highlighted gall bladder wall thickness of > 3mm as an independent risk factor for conversion. The purpose of our study is to predict the feasibility of cholecystectomy laparoscopically bases on the pre-operative ultrasound guided measurement of gall bladder wall thickness.Methods: It is a retrospective study conducted in the Department of Surgery, Himalayan Institute of Medical Sciences (HIMS) from June 2016 to September 2017. Patient’s pre-operative complete haemogram, liver function tests were also analyzed. Gallbladder wall thickness was estimated by using the maximal obtainable measurement at the fundus. A thin gallbladder wall was less than 3 mm in diameter. A thick gallbladder wall was 3 mm or greater in diameter.Results: A total of 192 patients were included in this study. Most of the patients were of the age group between 30-40 years, with average age of 37 years and 70% of the patients were females. Out of 192, 176 patients underwent laparoscopic cholecystectomy and 16 patients required conversion to open surgery. Ninety patients (46.8%) had cholecystectomy for acute cholecystitis and one hundred two patients (53.15%) had cholecystectomy for chronic cholecystitis. The gallbladder wall was found to be greater than 3 mm in 23 patients (25.5%) with acute calculous cholecystitis and greater than 3 mm in 25 patients (24.5%) with chronic calculous cholecystitis. Forty-eight patients, out of a total of 192, had a gallbladder wall thickness greater than 3 mm by preoperative sonography and 16 of these patients (33.3%) required conversion to an open cholecystectomy.Conclusions: Gall bladder wall thickness bases on ultrasound is a good predictor for difficult cholecystectomy and conversion to open surgery.

scholarly journals Early Laparoscopic Cholecystectomy with Continuous Pressurized Irrigation and Dissection in Acute Cholecystitis

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
I. Ozsan ◽  
O. Yoldas ◽  
T. Karabuga ◽  
U. M. Yıldırım ◽  
H. Y. Cetin ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Hospital Admission ◽  
Acute Cholecystitis ◽  
Symptom Onset ◽  
Open Surgery ◽  
Bile Leak ◽  
Conversion To Open Surgery ◽  
Conversion Rates ◽  
Pressurized Irrigation ◽  
Dissection Technique

Background. The aim of this study was to evaluate the preliminary results of a new dissection technique in acute cholecystitis.Material and Method. One hundred and forty-nine consecutive patients with acute cholecystitis were operated on with continuous pressurized irrigation and dissection technique. The diagnosis of acute cholecystitis was based on clinical, laboratory, and radiological evidences. Age, gender, time from symptom onset to hospital admission, operative risk according to the American Society of Anesthesiologists (ASA) score, white blood cell count, C-reactive protein test levels, positive findings of radiologic evaluation of the patients, operation time, perioperative complications, mortality, and conversion to open surgery were prospectively recorded.Results. Of the 149 patients, 87 (58,4%) were female and 62 (41,6%) were male. The mean age was46.3±6.7years. The median time from symptom onset to hospital admission 3.2 days (range, 1–6). There were no major complications such as bile leak, common bile duct injury or bleeding. Subhepatic liquid collection occurred in 3 of the patients which was managed by percutaneous drainage. Conversion to open surgery was required in four (2,69%) patients. There was no mortality in the study group.Conclusion. Laparoscopic cholecystectomy with continuous pressurized irrigation and dissection technique in acute cholecystitis seems to be an effective and reliable procedure with low complication and conversion rates.

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