JK Science (Oct 2007)
Conversion In Laparoscopic Cholecystectomy: An Evatuation Study
Abstract
In the present study, we studied the various reasons for conversion in laparoscopic cholecystectomy; andrecommended various methods and measures to decrease the incidence of conversion and associatedcomplications with this procedure. One hundred and seventy six patients in age group of 20-55 years,M:F ratio as 1:9 with body weight in range of 45-65 kilogram, who were having cholelithiasis withoutcholedocholithiasis and contraindication for general anaesthesia underwent laparoscopic cholecystectomybetween Jan 2002 and Dec 2003. There were a total of ten surgeons performing laparoscopiccholecystectomy out of which two surgeons had experience of more than 200 laparoscopiccholecystectomies. Twenty one patients (11.93%) out of a total of one hundred and seventy six (11.93%)had to be converted to open cholecystectomy for reasons which included dense omental or visceraladhesions- 5(2.84%), postoperative adhesions with parieties and viscera (intestines) - 3 (1.70%),uncontrollable bleeding from liver bed - 3 (1.70%), uncontrollable bleeding from cystic artery - 2(1.14%)unclear anatomy - 2(1.1.4%), cholecysteoduodenal fistula - 1(0.57%), common bile duct injury - 1 (0.57%),cirrhotic liver with shrunken gallbladder - 1(0.57%), spillage of stone - 1(0.57%), pneumoperitoneumrelated complications - 1(0.57%), instrument/equipment failure - 1 (0.57%).Good Laparoscopic skill, adequate experience and innovations are prerequisites for safe and cost-effectivelaparoscopic cholecystectomy thereby reducing conversion rate.
