Rate of conversion of laparoscopic cholecystectomy to open cholecystectomy; A retrospective analytical study

Aim: to analyse the incidence of intra operative risk factors responsible for conversion from laparoscopic to open cholecystectomy in our setting. study design: a retrospective analytical study of patients who underwent laparoscopic surgery from june 2009 to june 2012,conducted at the surgical unit 2 of the services hospital lahore,pakistan. methods: all those patients who underwent laparoscopic cholecystectomy (n-283) and were converted to open surgery (n = 10) were enrolled as cases. the reason behind the conversion and factors leading to it were recorded. results: a retrospective analysis in which a total of 283 patients were studied with age ranging from 25-65 years with m: f ratio,2:8 and body weight in range of 45-95 kilogram. ten patients (3.5%) out of a total of two hundred eighty three (283) had to be converted to open cholecystectomy for reasons which included dense omental or visceral adhesions- 2(0.7%),mirizi's syndrome - 2(0.7%),intrahepatic thick wall gall bladder- 2 (0.7%),carcinoma of gall bladder- 1 (0.4%),empyema gall bladder-1 (0.4%),cirrhotic liver with shrunken gall bladder-1 (0.4%),perforated gall bladder-1 (0.4%). the percentage of successful cholecystectomy was 96.5% (273 out of 283 cases) while the rate of conversion into oc was 3.5% (10 out of 283 cases). conclusion: the etiology responsible for conversion of lc into oc is multifactorial,however proper preoperative assessment,good laparoscopic surgical skills and equipment,adequate experience and innovations are important factors in carrying out successful laparoscopic cholecystectomies.