Preoperative Clinical and Ultrasonic Parameters Predicting Conversion from Laparoscopic Cholecystectomy to Open Cholecystectomy

Abstract

Pre-operative prediction of a difficult laparoscopic cholecystectomy (LC) can help the patient as well as the surgeon to prepare better for the intra-operative risk and the risk of conversion to open cholecystectomy. In 200 eligible patients who underwent LAPAROSCOPIC CHOLECYSTECTOMY during May 2004 to January 2006, in Azadi hospital in Kirkuk patient characteristics, clinical history, laboratory data, ultrasonography results and intra-operative details were prospectively analyzed to determine predictors for difficult LC. Twenty three patients (11.4%) out of 200 required conversion to open cholecystectomy. Significant predictors for conversion were: body mass index >30 Kg/m2 , Male gender, past history of acute cholecystitis, past history of upper abdominal surgery & Gall bladder wall thickness exceeding 3 mm..
Clinical and ultrasonograpic factors can help in predicting difficult laparoscopic cholecystectomy and likelihood of conversion to open surgery.