Papot Charutragulchai, MD, Chotirot Angkurawaranon, MD, Kannikar Laohavichitra, MD, Jerasak Wannapraset, MD, Thawee Rattanachu-ek, MD, Siripong Sirikurnpiboon, MD. Department of Surgery, Rajavithi Hospital, Bangkok, Thailand, 10400
Background: Laparoscopic cholecystectomy (LC) is the standard procedure for cholecystectomy. However, in some patients, LC cannot be successfully performed requiring conversion to open cholecystectomy (OC). This study was to analyze the factors affection conversion of LC to OC.
Method: Retrospective medical records review between January 2008 to September 2016 from a single tertiary referral hospital, Rajavithi Hospital, Bangkok, Thailand. Patients who underwent elective LC and was converted to OC was analyzed. Exclusion criteria were cases that required emergency LC.
Result: A total number of 2,045 patients underwent elective LC during the 9 year review. Only 123 patients had conversion to OC (6.01%). The mean age was 59 (±13.6) years. Sixty-four patients were male (52%) and 59 patients were female (48%). Most patients had ASA score£2 (87%). The diagnosis of the patients for elective LC were symptomatic gall stone (51.2%), subsided cholecystitis (34.1%), choledocholithisis post endoscopic removal (12.1%), and gall stone pancreatitis (2.43%). The most common factor influencing conversion is unclear anatomy in Calot’s triangle (103 patients, 83.7%). The remaining factors were bleeding (6 patients, 4.87%), bile duct injury (6 patients, 4.87%), cholecystoduodenal fistula (3 patients, 2.43%), injury to other organ (3 patients, 2.43%), common bile duct exploration (1 patient, 0.81%), and other (1 patient, 0.81%).
Conclusion: The factors affecting conversion of LC to OC in elective setting were most commonly unclear anatomy of the Calot’s triangle.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 86555
Program Number: P123
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster
sages_adbutler_leaderboard