Reasons and Morbidity of Conversions in Laparoscopic Cholecystectomy

摘要

A total of 619 patients (68 males and 551 females) underwent laparoscopic cholecystectomy. Forty (6.46%) patients were converted to open surgery. Regarding preoperative variables males had higher conversion rate of 72.5 %( p <0.0001). Mean age of the converted group was 55.2 +2.5 year and mean age of laparoscopic group was 42.6 + 3.8 year (p 0.0003). Conversion was more in patients with acute cholecystitis (p value <0.0001). Obscured anatomy of Calot’s triangle (45%) and equipment failure (15%) were major reasons for conversion. Operative complications leading to conversion were bile duct injury (5%), haemorrhage (7.5%), duodenal injury (1%), colonic injury (1%) and common bile duct stones (5%). Patients in conversion group had higher rate of postoperative morbidity. This included wound infection (10.0%), fever (12.5%), bile leakage (5%) and intra abdominal collection (5%). It increased the hospital stay to 4.3 + 0.3 days which for the laparoscopic group was 1.6 + 0.1 day (p <0.0001).