Preoperative Factors Leading to Conversion to open Procedure in Laparoscopic Cholecystectomy

Objectives: To identify and assess the role of factors for conversion of laparoscopic to open cholecystectomy. Study Design: Cross sectional comparative study Place and Duration: District Headquarters Hospital, Rawalpindi and Holy Family Hospital, Rawalpindi from January 2011 to December 2012. Material and Method: 240 patients were included in the study. The variables studied were age, sex, obesity, diabetes, hypertension, previous attacks of acute cholecystitis and pancreatitis, biliary colics, history of jaundice, pain, fever, a high leukocyte count and ultrasound evidence of cholecystitis. Analysis of different parameters, including patient related, intra-operative factors and surgeon related were performed and test for significance applied when indicated. Results: Thirty two (13.3%) operations were converted. Factors significantly associated with conversion were male gender, Pain in last 3 months, multiple calculi, gall bladder wall and WBC count. Conclusion: Preoperative evaluation of such factors in patients due for laparoscopic cholecystectomy may help predict difficulties for the procedure, allow patients to be better informed about possible conversion or even elective choice to open procedure.