Study on preoperative factors predicting the conversion of laparoscopic cholecystectomy to open cholecystectomy

AIM OF THE STUDY: To preoperatively predict the conversion of laparoscopic cholecystectomy using clinical, haematological and radiological factors. MATERIALS AND METHODS: A total of 50 patients with cholelithiasis admitted at Madras Medical College & Rajiv Gandhi Government General hospital, Chennai and planned for laparoscopic cholecystectomy were included in this study. Patient factors such as Age, Sex, Height, Weight, BMI, previous attacks of cholecystitis, haematological factors such as WBC count, total bilirubin, serum amylase, serum alakaline phosphatase and C=Reactive protein and Ultrasonographic factors such as Gallbladder status, wall thickness and pericholecystic collection were recorded and analysed. RESULTS: Male gender, increased WBC count, increased total bilirubin and alkaline phosphatase, increased C-Reactive protein, positive Blood culture were associated with increased risk of conversion and among the ultrasonographic features contracted gallbladder, increased gallbladder wall thickness and presence of pericholecystic collection were associated with increased risk of conversion to open cholecystectomy. CONCLUSION: Our results demonstrate that an accurate and easily derived estimation of risk for conversion from laparoscopic cholecystectomy to open cholecystectomy can be obtained from readily available preoperative data. These factors can predict difficulty to be encountered during laparoscopic cholecystectomy and help in making a decision for conversion thus shortening the duration of surgery thereby preventing unnecessary complications