DETERMINANTS THAT PREDISPOSE TO CONVERSION OF LAPAROSCOPIC CHOLECYSTECTOMY TO OPEN CHOLECYSTECTOMY IN A TERTIARY HEALTH-CARE CENTER IN INDIA

Karthikhaeyan TR; Keerthi Visagan; Vasantha Ragavan A; Ankit Kumar Sharma; Rajasenthil V

doi:10.22159/ajpcr.2023.v16i10.49148

Authors

Karthikhaeyan TR Department of General Surgery, KMCH Institute of Health Sciences and Research, Coimbatore, Tamil Nadu, India. https://orcid.org/0000-0003-1953-3117
Keerthi Visagan Department of General Surgery, CMC, Vellore, Tamil Nadu, India. https://orcid.org/0009-0001-5177-0692
Vasantha Ragavan A Department of General Surgery, KAPVGMC, Tiruchirapalli, Tamil Nadu, India. https://orcid.org/0009-0009-4714-6174
Ankit Kumar Sharma Department of Urology, Manipal Hospitals, Whitefield, Bengaluru, Karnataka, India. https://orcid.org/0000-0002-7818-4765
Rajasenthil V Department of General Surgery, SRIHER, Chennai, Tamil Nadu, India. https://orcid.org/0000-0003-2568-232X

DOI:

https://doi.org/10.22159/ajpcr.2023.v16i10.49148

Keywords:

Acute cholecystitis, Complicated gallbladder, Laparoscopic cholecystectomy, Open cholecystectomy, calot’s triangle, ultrasound abdomen

Abstract

Objectives: The aim of this study was to analyze the patient and disease-related factors of gallstone disease and also to identify pre-operative clinical, laboratory, and ultrasonic predictors that predispose to conversion of laparoscopic to open cholecystectomy.

Methods: The study was prospectively conducted over 1-year duration in a tertiary care center in India. Demographic, hematological, and radiological data were recorded for all participants and compared to assess predictors of conversion from laparoscopic to open cholecystectomy.

Results: A total of 526 patients participated in the study. Thirty-two cases were converted to open with 6.08% conversion rate. The common intraoperative causes of conversion were frozen Calot’s triangle, dense adhesions, and empyema gallbladder. The significant predictors of conversion were found to be a previous episode of acute cholecystitis (p=0.003), previous upper abdominal surgery (p=0.001), total leukocyte count (p=0.012) with neutrophils (p=0.005), gallbladder wall thickness >5 mm (p=0.0082), and presence of pericholecystic fluid (p=0.0184).

Conclusion: The above-mentioned determinants can be used to predict the chances of conversion in a patient planned for laparoscopic cholecystectomy so that the patient can be counseled regarding the risk of conversion and informed consent can be obtained, and the surgical team can be adequately prepared.

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Author Biographies

Karthikhaeyan TR, Department of General Surgery, KMCH Institute of Health Sciences and Research, Coimbatore, Tamil Nadu, India.

ASSISTANT PROFESSOR , DEPARTMENT OF GENERAL SURGERY

Keerthi Visagan, Department of General Surgery, CMC, Vellore, Tamil Nadu, India.

SENIOR RESIDENT, DEPARTMENT OF GENERAL SURGERY

Vasantha Ragavan A, Department of General Surgery, KAPVGMC, Tiruchirapalli, Tamil Nadu, India.

ASSISTANT PROFESSOR, DEPARTMENT OF GENERAL SURGERY

Rajasenthil V, Department of General Surgery, SRIHER, Chennai, Tamil Nadu, India.

PROFESSOR, DEPARTMENT OF GENERAL SURGERY

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