INTRODUCTION: Early conversion from laparoscopic to open cholecystectomy for patients with gangrenous cholecystitis has been advocated. This study investigated the impact of early conversion on patient outcome.
AIMS & METHODS: Data from all patients with gangrenous cholecystitis undergoing laparoscopic cholecystectomy between 1995 and 2006 whose procedure had been converted to open surgery were collected and analyzed. Morbidity, length of stay, intensive care unit admission, and operative time served as outcome measures
RESULTS: Of the 311 patients in the study with gangrenous cholecystitis, 38 (12,22 %)underwent conversion to open cholecystectomy. The conversion was early for 17 patients (44,74 %), necessary after intraoperative incidents for 9 patients (23,69%) and deliberate after an extended attempt at completion of the laparoscopic cholecystectomy for 12 patients (31,58%) There was no difference in the overall morbidity among the groups whereas the lengths of hospital stay appeared to be longer in the early conversion group. The operative time was significantly shorter after early conversion.
CONCLUSION: Laparoscopic cholecystectomy is not feasible for all patients with gangrenous cholecystitis. However, a concerted effort to perform the cholecystectomy with the minimally invasive approach does not have an adverse impact on patient outcome and is likely to benefit patients although it poses a moderate risk of conversion.
Program Number: P315