| ORIGINAL ARTICLE |
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| Year : 2020 | Volume
: 17
| Issue : 4 | Page : 341-346 |
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Preoperative predilection of conversion to open in laparoscopic cholecystectomy
Alaa Bakir Raheem1, Hussein Oudah Al-Jasmawi2, Ameer Kadhim Al-Humairi3
1 Department of Surgery, Al-imam Alsadeq Teaching Hospital, Babil Health Directorate, Babylon Province, Hilla, Iraq
2 Department of Surgery, Hilla Teaching Hospital, Babil Health Directorate, Babylon Province, Hilla, Iraq
3 Department of Community Medicine, College of Medicine, University of Babylon, Hilla, Iraq
Correspondence Address:
Ameer Kadhim Al-Humairi
Department of Community Medicine, College of Medicine, University of Babylon, Hilla
Iraq
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/MJBL.MJBL_42_20
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Background: With the new era of laparoscopic surgery within the last three decades, laparoscopic cholecystectomy emerges as the golden standard treatment for gallbladder disease and cholitiasis; laparoscopic treatment not always seems to be successfully completed laparoscopically. Making attempts for completing the procedure it is laparoscopically is challenging some times and conversion occurs. This study is to discuss the conversion main causes try to detect patients at risk factors for conversion in laparoscopic cholecystectomy. Objectives: The aim of the study was to predict which patients are having greatest risk factors for possible conversion to open procedure instead of being completed laparoscopically. Materials and Methods: This is a cross-sectional study performed retrospectively from October 2007 to January 2019 to detect the patients at risk factors for conversion in patients who started laparoscopically and conver to open approach occurred started by started via. All the procedures were performed by the same operator team surgeon. Surgery was done at AL-Hilla General Teaching Hospital, AL-Sadeque General Teaching Hospital, and in many private hospitals in Babylon Governance. A routine preoperative history, clinical examinations, and US, EX, and laboratory investigations were done for all patients, while abdominal Computerized Axial Tomography (CAT) scan, endoscopic retrograde cholangiopancreatography, and magnetic resonance cholangiopancreatography were done for selected patients if indicated. Many patients have different associated comorbid diseases. There are no selection criteria as all patients have no contraindications for laparoscopic surgery. Results: This study included 344 patients; 62 males (18.0%) and 282 females (82.0%). There are different age groups: the mean age is 42.38 (11–85) years for different gallbladder diseases including calculus cholecystitis, acalculus cholecystitis, microlithiasis, cholecystitis causing biliary pancreatitis, and empyema of gallbladder. Data were analyzed retrospectively as the results of surgical procedures outcome which show that only 11 patients (3.2%) whom underwent conversion from a total of 344 patients of the study. Conclusion: There are several factors associated with increased risk of conversion, but this study showed that there is no association with age, diabetes mellitus, and abnormal anatomical variations as risk factor for conversion.
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