Pervez Iqbal, Mohammad Saddique, Tufail Ahmed Baloch.
Factors leading to conversion in Laparoscopic Cholecystectomy.
Pak J Surg Jan ;24(1):9-11.

Objective: To determine the reasons for conversion of Laparoscopic Cholecystectomy to open surgery in our setup. Design & Duration: A case series from January 2000 to June 2007. Setting: Surgical Unit I & IV of Civil Hospital Karachi, Surgical Unit VIII of Lyari General Hospital and two private hospitals of Karachi. Patients: A total of 340 patients who underwent Laparoscopic Cholecystectomy. Methodology: Detailed history, physical examination and investigations were carried out. Patients were operated by a senior surgeon. Cases that required conversion from Laparoscopic to open surgery were analyzed and the factors responsible for such conversion were studied. Results: Out of 340 patients 32 (9.4%) required conversion to open procedure. Factors responsible for these conversion were dense adhesions in 8(2.4%), empyema gall bladder in 4(1.2%), contracted gall bladder in 3(0.9%), haemorrhage in 3(0.9%), and CBD injury and carcinoma gall bladder in 2(0.6%) each. Instrument failure and repeated power breakdowns with backup failure were also recognized as important factors responsible for 10(2.9%) conversions. Conclusion: Conversion of Laparoscopic to open procedure may be life saving in difficult situations. Conversion rate can be reduced by addressing the preventable factors.

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