Risk factors for conversion to open surgery in laparoscopic cholecystectomy: A single center experience
1Bilkent Hospital, General Surgery, Ankara, Turkey
2Baskent Universty, General Surgery, Istanbul, Turkey
Purpose: This study aims to demonstrate the demographic characteristics for the laparoscopiccholecystectomy surgeries performed in the general surgery clinics of our hospital, to identify the rate of conversion to open surgery and the main reasons for convert to open surgery.
Material and Methods: Medical records of a total of 1,294 patients who underwent laparoscopic cholecystectomy in our hospital between October 2013 and May 2017 were retrospectively reviewed and the rates of conversion to open surgery based on age groups were recorded.
Results: Of these patients, 1,191 were females (92.0%) and 103 (7.9%) were males. The mean age was 48.6 ± 13.2 (range: 18 to 89) years. Indications for surgery were cholelithiasis in 1,195 patients (92.4%), acute cholecystitis in 56 patients (4.4%), and gallbladder polyps in 43 patients (3.3%). The procedure was conversion to open surgery in 41 patients (3.16%), while 12 (0.9%) developed intraoperative complications. There was no mortality. The mean length of hospital stay was 1.2 (range: 1 to 6) days. The main reasons for conversation to open surgery were as follows: adhesions in the Calot’s triangle (n=3), acute cholecystitis (n=29), choledocholithiasis (n=2), adhesions due to previous surgery (n=1), dissection difficulty (n=2), organ damage (n=2), anatomic variation (n=1), and stone expulsion (n=1).
Conclusion: Acute cholecystitis appears to be the most important factor increasing the rate of conversion to open surgery during laparoscopic cholecystectomy. Male sex, increased age, and the presence of acute cholecystitis are the main factors increasing the risk of convert to open surgery.
Keywords: Laparoscopic cholecystectomy, open cholecystectomy, complication