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Predictive factors for conversion of laparoscopic cholecystectomy
1Sagar Apollo Hospital, 30th Cross, Tilak Nagar, Jayanagar Extension, Bangalore, 560041 India.
The Indian Journal of Surgery
|December 4, 2012
Summary
Laparoscopic cholecystectomy conversion to open surgery occurred in 2.6% of patients. Raised preoperative alkaline phosphatase was a significant predictor, though predicting conversion preoperatively remains challenging.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Medical Informatics
Background:
- Laparoscopic cholecystectomy is the standard treatment for gallbladder diseases.
- Conversion to open cholecystectomy is sometimes necessary.
- Predicting conversion factors is clinically important.
Purpose of the Study:
- To identify preoperative factors predicting conversion from laparoscopic to open cholecystectomy.
- To determine intraoperative reasons for conversion.
- To assess the predictability of conversion factors.
Main Methods:
- Retrospective review of 526 laparoscopic cholecystectomy cases at Sagar Apollo Hospital (July 2003 - November 2006).
- Analysis of patient database for preoperative and intraoperative data.
- Statistical analysis to identify significant predictors of conversion.
Main Results:
- 14 out of 526 patients (2.6%) required conversion to open cholecystectomy.
- Elevated preoperative alkaline phosphatase levels were statistically significant predictors of conversion.
- Difficulty in delineating Calot's triangle anatomy was the most common intraoperative reason for conversion.
Conclusions:
- Preoperative alkaline phosphatase may indicate a higher risk of conversion.
- Intraoperative anatomical challenges are primary drivers for conversion.
- Preoperative prediction of conversion remains difficult despite identified factors.
