Conversion Rate in Laparoscopic Cholecystectomy: A Review of 300 Cases


background : Prediction of a difficult laparoscopic cholecystectomy (LC) can help the patient as well as the surgeon to be better prepared for the intra-operative risk and the risk of conversion to open cholecystectomy. The difficult gallbladder is the most common 'difficult' laparoscopic surgery being performed by general surgeons all over the world and the potential one that places the patient at significant risk. We present our experience of 300 cases since September 2007 to December 2009 in a single center with respect to conversion to open cholecystectomy.
AIM: evaluation of difficult laparoscopic cholecystectomy and conversion rate in different 300 cases of cholelithiasis.
Methods: Patients who underwent laparoscopic cholecystectomy (LC) from September 2007 to December 2009 were analyzed. The cases were analyzed in relation to conversion rate to open surgery; factors affecting pulmonary disease were not included in the study.
Results: Out of 300 cases, 52 patients (17.33%) were identified as difficult cases. Laparoscopic cholecystectomy was successfully completed in 295 patients with a completion rate of 98.33%. Laparoscopic procedure had to be converted to the open procedure in 5 patients with a conversion rate of 1.66% of the total LCs performed and 9.6% of the difficult cases. Conversion had been done due to several reasons.
Conclusion: It can be reliably concluded that LC is the preferred method even in the difficult cases. Our study emphasizes that although the rate of conversion to open surgery and complication rate are low in experienced hands the surgeon should keep a low threshold for conversion to open surgery and it should be taken as a step in the interest of the patient rather than be looked upon as an insult to the surgeon.
Key words: conversion, laparoscopy, cholecystectomy.