Frequency and intraoperative reasons leading to conversion of laparoscopic cholecystectomy to open cholecystectomy in a tertiary care hospital at Karachi

Abstract

Objective: To determine the frequency of conversion of laparoscopic cholecystectomy to open cholecystectomy, and to assess the reasons behind the conversion in a public-sector tertiary care facility. Method: The descriptive, cross-sectional study was conducted at the Department of Surgery, Jinnah Postgraduate Medical Centre, Karachi, from October 28, 2022, to April 28, 2023, and comprised patients undergoing laparoscopic cholecystectomy. The operating consultant recorded intraoperative conversion and reasons behind the decision. Data was analysed using SPSS 23. Results: Of the 123 patients with mean age 37.2±7.4 years, 77(62.6%) were female and 46(37.4%) were male. Conversion to open cholecystectomy was done in 15(12.2%) cases. The reason for conversion was adhesions 5(33.3%), fibrosis at Calot’s triangle 4(26.7%), common bile duct injury 3(20.4%), difficult anatomy 2(13.3%) and gallbladder perforation 1(6.7%). Conclusion: The primary reason necessitating the transition from laparoscopic to open cholecystectomy was the presence of adhesions, with fibrosis at Calot's triangle and common bile duct injury also playing significant roles. Key Words: Cholecystectomy, Laparoscopic, Cholelithiasis, Fibrosis, Adhesions, Biliary tract diseases.