A Prospective Study to Predict the Preoperative Risk Factors for Conversion of Laparoscopic to Open Cholecystectomy
Journal Title: International Journal of Contemporary Medicine surgery and Radiology - Year 2017, Vol 2, Issue 4
Abstract
Introduction: It was in mid 1980’s that laparoscopic cholecystectomy was introduced for symptomatic cholelithiasis. Later with few years of study, it became the gold standard for managing cases of symptomatic cholelithiasis. There have been various evidences in the literature that have shown that the incidence of conversion to open case is 2% to 22%. The aim of the present study was to evaluate the various risk factors associated with the conversion of laparoscopic cholecystectomy to open cholecystectomy. Material and methods: The present prospective study was conducted in the department of surgery, Guru Gobind Singh Medical College, Faridkot, Punjab. The study was conducted from March 2014 to August 2015. The study included all the symptomatic patients with gall stone disease. After the surgery, patients were divided into two groups, firstly those who completed laparoscopic cholecystectomy and secondly those who were converted into open cholecystectomy. The following factors were assessed for each patient. They were age, gender, BMI, level of TLC and alkaline phosphatase. All the data was recorded in a tabulated form and analysed using SPSS software. Data was expressed as percentage of total data. Chi square test was applied as a test of significance and p value of less than 0.05 was taken as significant. Results: There were 95 patients in Group I and 5 patients in Group II who were less than 50 years of age. There were 40 patients in Group I and 8 patients in Group II who were greater than or equal to 50 years to age. There were a total of 86 females and 13 males in laparoscopic group and 8 females and 5 males in Group II. There were a total of 6 patients with history of surgery. There were 2 patients in Group I and 6 patients in group II who had the history of upper abdominal surgery. Sensitivity amongst patients with history of upper abdominal surgery is 97.9%. Conclusion: From this study we can conclude that parameters like age, sex, obesity, history of upper abdominal surgery, raised total leukocyte count, raised alkaline phosphatise and contracted gall bladder are risk factors and predictors for conversion to open cholecystectomy.
Authors and Affiliations
Vikas Goyal, Nitin Nagpal, Monica Gupta, Rohit Kapoor
Keywords
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